needle into the vagina. saline is flushed through the needle and the needle is replaced by the trocar. depending on the clinician, lactated ringer's may be used instead of saline. once the trocar is placed, an optic scope is inserted. upon completion of the procedure, some patients may require sutures to stop any remaining bleeding. this method tends to be better for classifying tubal disease as inspection of the inner structure allows for visualization of any lesions, adhesions, and endometriomas. one benefit of this procedure is that no incisions are required and it can be completed in a clinic office. the disadvantages are the risk of bleeding, abdominal tenderness, and that insertion of the vaginal trocar can cause possible rectal injury. when the needle is initially inserted, it is also possible for accidental perforation to the uterus wall or bowels, though this is less likely to happen. while this method is extremely helpful, those with increased risk of bleeding, infections, or ovarian cysts should not undergo this procedure. chlamydia serology chlamydia immunoglobulin g antibody tests (cat) are used to explore tubal occlusions and injuries that may be caused by chlamydia trachomatis. these assays include immunofluorescence tests (including microimmunofluorescence) and elisa. while this method is noninvasive and easy to carry out, there is a chance of false-positive results. these tests can recognize antibodies to different species of chlamydia as well as even other gram-negative bacteria. therefore, these tests are usually used as a screening test. if negative, unnecessary testing is avoided; if positive, more invasive tests are required. gallery dye visible in the fallopian tube blue dye filling in the pouch of douglas blue dye exiting from fallopian tube laparoscopy of the uterus and fallopian tubes endometriosis of the fallopian tube, an example of tubal occlusion