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What Does My HSG Test Report Indicate?

Posted on Wed, 7 Jun 2017

Question: Hello Doctor,

My recently done HSG suggests that both my Fallopian tubes are blocked from fimbrioal end (bilateral fimbrial end blockage). It also says that persistent filling defect along the left lower uterine cavity suspicious for synechiae.

What is the way forward now and what are my chances of successful IVF.

Regards

Answered by Dr. Deepti Verma (20 minutes later)

Brief Answer:
Tuberculosis should be ruled out

Detailed Answer:
Hi dear,
I have gone through your question and understand the concerns.
Bilateral fimbrial blockage with uterine synechiae is suggestive of uterine and tubal tuberculosis.
In this situation, you should get a Mantoux test and chest X ray done to confirm the diagnosis.
Further antitubercular treatment should be done accordingly.
IVF results are not good if there is untreated tuberculosis in uterus and fallopian tubes.
However, if treatment is done, then the results are good.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Deepti Verma (46 minutes later)

Is my case that of Hydrosalpinx. I hv read on internet that such patients have a very poor IVF outcome. Is this the case ?

I am very concerned about this. Kindly guide.

Answered by Dr. Deepti Verma (4 hours later)

Brief Answer:
Certain procedures are done

Detailed Answer:
Hi dear,
Whenever there is hydrosalpinx, a course of antitubercular drugs is given prior to doing IVF. Moreover, the openings if the tubes in the uterus is blocked by the hysteroscopy so that the infected material do not enter the uterus and hence not affect the chances of pregnancy by IVF.
These two steps, if done, do not affect the chances of pregnancy by IVF in a patient of hydrosalpinx.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepti Verma (14 hours later)

My doctor has asked me to come on 1st day of periods in next cycle to do a biopsy to confirm TB.

She is suggesting if it is TB.. then get the TB treatment first and anything else afterwords. If it is a routine infection... then it I'll be treated first and then go for laparoscopy and fimbrioplasty. If nothing works... then IVF.

I am not very clear on this Uterine Synechiae thing. Will it impact on carrying a full term pregnancy. Will it get cured after TB treatment or will surrogacy remain my only option.

Regards

Answered by Dr. Deepti Verma (26 minutes later)

Brief Answer:
Stepwise treatment advised

Detailed Answer:
Hi dear,
Uterine synechiae usually form due to tuberculosis infection.
It gets treated by antitubercular treatment.
Biopsy of the endometrium on first day is confirmatory for tuberculosis infection.
So, it should be done prior to any procedure.Patients treated with antitubercular treatment usually respond and their synechia may heal, in which the chances of normal pregnancy are there.
So, I suggest you not to panic and go stepwise for the treatment.
Regards
Dr Deepti Verma

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Above answer was peer-reviewed by : Dr. Kampana