Objective: To evaluate the efficiency of radionuclide hysterosalpingography (HSG) by using 99mTc hexamethyl propyleneamine oxime (HMPAO)-labeled human spermatozoa in the assessment of fallopian tube patency in infertile couples. Design: Fifteen infertile female patients were inseminated with their husbands' radiolabeled spermatozoa immediately after cessation of menses. Setting: University-based academic hospital. Main Outcome Measure(s): The time course of radioactivity and scintigraphic images of the uterus and the parauterine tissues implying tubal patency were evaluated and compared by using laparoscopy and HSG. Result(s): We demonstrated T max (time to peak radioactivity at periovarian sites) for right and left tubes to be 6.74 ± 2.66 and 5.91 ± 2.93 minutes (means ± SD), respectively. We also found 72% sensitivity and 75% specificity of spermatozoa labeled radionuclide HSG compared with laparoscopic findings for tubal patency. Conclusion(s): Radionuclide HSG with the husband's spermatozoa seems to be a potentially useful method of assessing patency of the fallopian tubes. The safety dose of this procedure is comparable to conventional HSG. However, more comparative studies are needed to evaluate advantages and disadvantages of this technique.