In recent years, the incidence of infertility has been on the rise, and accurately evaluating the tubal status is of great significance in the diagnostic work-up of infertile women. HyCoSy has a certain proportion of false positives and false negatives in the evaluation of fallopian tube patency. The new third-generation drug-or gene-loaded microbubble contrast agents will largely achieve the dual purpose of diagnosis and treatment in clinical application, especially in transvaginal four-dimensional hysterosalpingo-contrast sonography (TVS 4D-HyCoSy), which has significant clinical value in assessing tubal patency and perifallopian tube adhesions. This study mainly discusses the selection of current diagnostic methods for tubal infertility, the technical challenges, and suggestions for ultrasonic diagnosis and postoperative treatment.