Assessment of Tubal Patency in Women with Endometriosis

The assessment of tubal patency is similar in women with endometriosis and those with other causes of infertility. The patency of the fallopian tubes can be assessed by hysterosalpingography (HSG), hystero-salpingo contrast sonography (HyCoSy), and laparoscopic chromopertubation. HSG allows to evaluate the tubal patency in patients with endometriosis, but it does not allow to diagnose endometriosis or to assess its severity. Because of its invasive nature, laparoscopy should be reserved for those women needing surgery and not only for evaluating the fallopian tubes. HyCoSy should be the first-line investigation of tubal patency in women with endometriosis. It allows a one-step evolution of tubal patency, uterus (myometrium and endometrium), deep endometriosis, and ovarian endometrioma.