Concierge fertility imaging · London
Tubal assessment, HyCoSy, HSG or laparoscopy to confirm tubal patency in the fertility workup.
A tubal assessment confirms whether the Fallopian tubes are open — a critical step in the fertility workup. Options include HyCoSy (ultrasound-based), HSG (X-ray-based) and laparoscopy + dye. Best chosen based on background risk of tubal disease.
Key facts
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Definition
A structured assessment that confirms whether the Fallopian tubes are open — a critical step in the fertility workup.
- 02
Consultant gynaecology-led
Performed and interpreted by a consultant fertility gynaecologist, not a generalist.
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Three main options
HyCoSy (ultrasound), HSG (X-ray) or laparoscopy and dye — chosen on your background risk.
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Radiation-free with HyCoSy
Ultrasound-based HyCoSy avoids ionising radiation and is generally the first-line choice.
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Outpatient with HyCoSy / HSG
Both are outpatient procedures — no general anaesthetic, no overnight stay.
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Foundation of the fertility workup
Tubal patency underpins whether natural conception, IUI or IVF is the right route.
Indicative pricing
What a private tubal assessment costs in London.
Indicative ranges across our partner fertility clinics. Send the details and we quote firm figures across two or three options.
In short
A HyCoSy in our network: £650–£1,100, with findings often the same day.
| Test | Indicative range | Typical duration | Report turnaround |
|---|---|---|---|
| HyCoSy (ultrasound-based tubal patency) | £650–£1,100 | 30 min | Same-day |
| HSG (hysterosalpingogram, X-ray-based) | £550–£950 | 20 min | Same-day |
| Laparoscopy and dye | £4,500–£7,500 | Day case | 1 week |
| Fertility consultation + tubal test | £850–£1,400 | 90 min | Same visit |
| Salpingectomy for hydrosalpinx (day case) | £5,500–£8,500 | Day case | 2 weeks |
| Full fertility workup (bloods + AMH + US + tubal) | £1,400–£2,600 | Half-day | Same-week |
Prices vary by clinic and by whether a consultant fertility opinion is bundled with the test. We come back with a firm quote within one working day.
The diagnosis journey
From consultation to fertility plan — what happens, in order.
One consultant fertility gynaecologist from first consultation to structured plan — often within days.
- 01
Before
Fertility consultation
Consultant gynaecology review — history, prior imaging, semen analysis and hormonal profile inform which test fits.
- 02
Before
Chlamydia screen + antibiotic cover
Chlamydia swab pre-procedure; prophylactic antibiotics given to reduce post-procedural pelvic infection risk.
- 03
Before
Follicular-phase booking (day 5–10)
Scheduled after menses and before ovulation — the safe window for contrast-based tubal imaging.
- 04
On the day
Method selected (HyCoSy / HSG / lap-and-dye)
The chosen test is confirmed on the day, with informed consent and a plan for pain relief.
- 05
On the day
Procedure performed
Contrast is passed through the cervix (HyCoSy / HSG) or dye is instilled at laparoscopy under general anaesthetic.
- 06
After
Structured report
Consultant report describing bilateral patency, blockage, hydrosalpinx and any uterine cavity findings.
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After
Structured fertility plan
Follow-up consultation translating findings into a concrete next step — natural conception, IUI, IVF or surgery.
What it shows
What a tubal assessment can identify.
A tubal assessment answers a specific question — are the Fallopian tubes open, and what does that mean for the fertility plan.
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Bilateral tubal patency
Both Fallopian tubes confirmed open — supports natural conception or IUI pathways.
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Unilateral tubal blockage
One tube blocked — often manageable, still compatible with natural conception on the patent side.
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Hydrosalpinx
Fluid-filled dilated tube — reduces IVF success and typically warrants salpingectomy before treatment.
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Peritubal adhesions (lap only)
Adhesions around the tubes seen at laparoscopy — often from previous infection or surgery.
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Uterine cavity anomaly
Septum, polyp or submucosal fibroid distorting the cavity — picked up by HyCoSy or HSG.
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Endometriosis (lap only)
Peritoneal deposits and endometriotic implants identified only at laparoscopy.
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Fibroid distortion
Fibroids indenting the cavity or occluding the tubal ostia — a treatable cause of subfertility.
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Red flag: hydrosalpinx bilateral — salpingectomy before IVF
Bilateral hydrosalpinges materially reduce IVF implantation and warrant surgical management first.
Treatment options
What follows a positive finding.
What each treatment route is actually for — from IVF for bilateral blockage through to selective surgical correction.
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IVF for bilateral tubal blockage
When both tubes are blocked, in-vitro fertilisation bypasses the tubes and is the definitive treatment route.
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Salpingectomy for hydrosalpinx before IVF
Laparoscopic removal of a hydrosalpinx before IVF materially improves implantation and live-birth rates.
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Laparoscopic adhesiolysis
Division of peritubal adhesions to restore tubo-ovarian anatomy in selected patients.
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Fimbrioplasty
Reconstruction of the fimbrial end of the tube — considered in mild distal disease.
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Tubal cannulation (selected cases)
Hysteroscopic or radiological cannulation of proximal tubal obstruction where anatomy permits.
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Hysteroscopic septum resection
Removal of a uterine septum identified on the cavity assessment — improves reproductive outcomes.
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Fertility follow-up
Structured review that translates findings into a concrete treatment plan and timeline.
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MDT review
Complex cases discussed at a fertility MDT — gynaecology, embryology and radiology aligned before treatment.
Red flags
Higher-risk histories that change the test.
These features raise the pre-test probability of tubal disease and often move the choice from HyCoSy or HSG toward laparoscopy and dye.
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Bilateral hydrosalpinx
Both tubes dilated and fluid-filled — surgical management typically precedes IVF.
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Prior chlamydia PID
Previous pelvic inflammatory disease materially raises the risk of tubal damage.
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Endometriosis with adhesions
Endometriosis distorting pelvic anatomy is best characterised at laparoscopy.
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Prior ectopic pregnancy
An ectopic history flags tubal disease and shapes which test to choose.
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Post-Caesarean adhesions
Adhesions after Caesarean section can distort tubo-ovarian relationships.
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Suspected genital TB
Genital tuberculosis causes a specific, severe pattern of tubal disease and needs targeted work-up.
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Previous tubal surgery
Prior salpingectomy, sterilisation reversal or ectopic surgery changes the test of choice.
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Prior ruptured appendicitis
A ruptured appendix in the past can cause right-sided tubal adhesions.
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Recurrent IVF failure
Repeated implantation failure may justify laparoscopic assessment to exclude an unrecognised hydrosalpinx.
Sources
The guidance this page is built on.
Reviewed against the current UK, European and US reproductive-medicine guidance.
Editorial standards
Reviewed by Pulse Atlas Editorial Board, .
Last reviewed 2026-07-30. Next scheduled review 2027-07-30.
- 01 Source
Royal College of Obstetricians and Gynaecologists — Fertility guidance.
Royal College of Obstetricians and Gynaecologists — Fertility guidance. - 02 Source
European Society of Human Reproduction and Embryology (ESHRE).
European Society of Human Reproduction and Embryology (ESHRE). - 03 Source
American Society for Reproductive Medicine (ASRM).
American Society for Reproductive Medicine (ASRM). - 04 Source
NICE. Fertility problems: assessment and treatment (CG156).
NICE. Fertility problems: assessment and treatment (CG156).
Frequently asked
Everything we get asked about tubal assessment.
Quick answers on test choice, timing, pain, hydrosalpinx and IVF.
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What is a tubal assessment?
A structured test that confirms whether the Fallopian tubes are open — a critical step in the fertility workup. Options include HyCoSy (ultrasound-based), HSG (X-ray-based) and laparoscopy with dye instillation.
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Which test is right for me — HyCoSy, HSG or laparoscopy?
HyCoSy is usually first-line for women with a low background risk of tubal disease. HSG is a good X-ray-based alternative. Laparoscopy and dye is reserved for higher-risk cases — endometriosis, prior PID, prior ectopic — where direct visualisation of the pelvis adds value.
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Is a tubal assessment painful?
HyCoSy and HSG typically cause period-like cramping for a few minutes. Simple analgesia beforehand helps. Laparoscopy is performed under general anaesthetic, so no pain is felt during the procedure.
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When in my cycle should the test be done?
Between day 5 and day 10 — after menses have finished and before ovulation. This window minimises infection risk and avoids inadvertent exposure of an early pregnancy to contrast.
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What is a hydrosalpinx and why does it matter?
A hydrosalpinx is a Fallopian tube blocked and dilated with fluid. It materially reduces IVF success rates, and evidence supports removing the affected tube (salpingectomy) before starting IVF.
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How quickly can I have IVF if both tubes are blocked?
Once bilateral tubal blockage is confirmed and any hydrosalpinx has been managed, IVF can typically begin at the next cycle — the tubal result itself doesn’t delay treatment.
Related tests
Looking for a different test?
-
HyCoSy
Ultrasound-based tubal patency test — often the first-line option.
Learn more -
Saline sonogram
Saline-infusion sonography to characterise the uterine cavity.
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Gynae ultrasound
Transvaginal pelvic ultrasound of uterus, ovaries and pelvic anatomy.
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All tests
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Endometriosis
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Menopause
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Coil IUD IUS Insertion And Removal
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Colposcopy With Lletz
Related treatment option.
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In practice, in London
Getting tubal assessment sorted in London, without the guesswork
With tubal assessment, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Public provision for tubal assessment is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.
The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For tubal assessment specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
There are a lot of consultants in London who can technically handle tubal assessment. Fewer who do it week in, week out for the exact question you’re bringing. We spend most of our time working out which is which — and being straight when a different test or a different specialist would serve you better. Everything runs to CQC, GMC and Royal College standards; the choice is about fit, not floor.