Transcervical Catheterization of the Fallopian Tubes (TCFT)

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated July 26, 2026

Transcervical catheterization of the fallopian tubes (TCFT) is a procedure that advances a specialized catheter-guidewire system through the cervix and uterine cavity to the uterotubal junction, under fluoroscopic guidance, to diagnose and clear partial proximal tubal occlusion. In NaProTechnology practice, it is performed in conjunction with selective salpingography and intratubal pressure measurement, which together distinguish true mechanical obstruction from spasm or contrast artifact.¹

Proximal tubal occlusion identified on standard HSG is frequently over-diagnosed. Spasm, debris, and incomplete contrast filling produce false-positive blocks. TCFT does not simply confirm or deny patency: it measures tubal resistance before and after catheterization. If pressure normalizes after the procedure, a true partial obstruction was present and cleared. If pressure remains elevated, the obstruction is complete and requires further surgical evaluation.

Hilgers and Yeung found that intratubal pressure normalized in 76% of partially obstructed tubes following catheterization, compared with only 29.5% of completely obstructed tubes.² Most partial obstructions clear with catheterization. Complete obstructions rarely do, and usually reflect organic pathology rather than a functional block. The procedure is timed to the proliferative phase of the cycle. For couples with proximal tubal factor infertility, TCFT restores the anatomical pathway for natural conception without surgical intervention. Where obstruction is complete rather than partial, the evaluation shifts toward surgical repair, such as tubal anastomosis or resection of the obstructed segment.

In NaProTechnology practice, TCFT is performed with intratubal pressure monitoring throughout the procedure. This is a refinement added to standard fluoroscopic tubal cannulation. That measurement component converts a binary open-or-closed assessment into graded patency data, making it a diagnostic procedure as well as a therapeutic one. The cycle-timed execution aligns the procedure with the window of maximal tubal accessibility and reproducible pressure baselines.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.