Brief Answer:
Please do not attempt any correction in the right tube.

Detailed Answer:
Dear XXXX,

I hope I have spelt your name correctly; if not, you may correct me.

Sluggishness in the right tube could be due to some slow infection like tuberculosis or any other subclinical infection. It needs thorough investigations. Now PCR tests for tuberculosis can provide the diagnosis within few hours. If you have got tubal tuberculosis, please get it treated first before attempting the pregnancy.

If there is no evidence of any infection; I feel you should ignore the sluggishness in the right tube, taking into consideration that your left tube is absolutely normal. The dictum in Gynaecology is that if one tube is patent and normal, and the other tube is blocked, no action should be taken.

The doctor you saw today seems to have passed reasonably logical and valid statement.

One tube is capable of collecting eggs released from both the ovaries and hence can make you pregnant. However, if any attempt in repairing the block tube is made, there is a risk that the normal tube may gat infection which can cause the block in that tube also.

I would appreciate if you upload the images along with the reports of hysterosalpingography which detected your tubal conditions for my review. Or was your tubal conditions detected by laparoscopy?

For any more information or advice, I am always available for you, Shai.

Dr. Nishikant Shrotri

---

Brief Answer:
One tube is sufficient

Detailed Answer:
Dear XXXXXXX

At the outset, let me assure you that you need not be deflated.

Yes, history of STI, in particular Gonorrhoea or Chlamydia infection could be possible cause behind the sluggishness of the tube. Had it not been treated so early, probably your both tubes would have got blocked completely.

Now please try to remove the misconceptions from your mind. There is nothing like strong ovary and weak ovary. Ovary is either releasing eggs or it is nor releasing eggs. It is as simple and as straight forward as that.

Secondly the tubes are not spread like the outstretched hands. They are hanging behind the uterus. Any tube can pick up egg from any ovary, from the same side or from the opposite side. In fact even if a woman has only left ovary and right tube, still she can conceive. So please get rid of such wrong ideas.

In fact, I have gone through your report. I am not concerned at all about so called sluggishness of one tube. So long as the tubes are showing peristaltic movements and are patent, do not worry. Let us see about the cyst on one of the ovary after a month. The other ovary may release the egg this time; and as I told you, this egg can be picked up by tube on the other side also. Even ipsilateral tube also can pick up this tube and take it to the uterus. And please understand that the fertilization takes place in the tube and not in the uterine cavity.

Yes, I do maintain my statement that if your one tube is normal, please do not go for any surgical procedure on the other tube lest the risk of good tube getting infec blocked. Even if it does not get infected, post-operative adhesions may damage the good tube. Have a faith in this good tube; it is capable of picking up the egg from both the ovaries to result in pregnancy.

Somehow, I also do not believe in such sluggishness of one tube. Therefore I wanted to see the X-rays. XXXXXXX if there is just transient spasm of the tubal opening on one side of the uterine cavity, naturally the XXXXXXX will enter the other tube more forcibly. Please shirk off your stress. One tube is sufficient to make you pregnant. Still try to rule out tuberculosis of the tube.

Now come on, boost up your mood and send me your all the previous reports and images.

Please do not hesitate to ask me any query or advice, XXXXXXX

Dr. Nishikant Shrotri

---

Brief Answer:
I woud appreciate images

Detailed Answer:
Dear XXXXXXX

I have already gone through your letter and have referred to them in my previous communication. I hoe you will upload the images and any other reports if done for my review. You do not need any treatment to fix one tube.

I am indeed happy to note that you are satisfied with my advice, You may please post a good review with 5 star rating for me.

For any other information, please go ahead and ask me, XXXXXXX

Dr. Nishikant Shrotri

---

Brief Answer:
No images.

Detailed Answer:
Dear XXXXXXX

There is no image of scanned photos at the bottom of the file. Some data could have got corrupted. Can you please rescan and reload it?

I am happy to note that you found my advice helpful to you.

Dr. Nishikant Shrotri

---

Brief Answer:
Ovulation monitoring by USG

Detailed Answer:
Dear XXXXXXX

The images are apparently within normal limits.

Your endometrium (uterine lining) is 9.9 mm thick which is quite good. Endometrium of thickness between 9 mm to 14 mm at the time of ovulation is conducive for implantation of the fertilized ovum. Your right ovary has a dominant follicle which may release the egg any time. This egg can be picked up by either of the tubes. So there does not seem to be any endometrial issue.

The left ovary though has a cyst, it appears to be simple cyst which may subside eventually. A follow up ultrasonography after next menses is indicated.

I feel you should not panic and shirk off the stress.

Now please submit yourself daily for ultrasonography for ovulation monitoring. In the report the size of dominant follicle is not mentioned. Usually the follicle ruptures to release an egg when it has reached size between 18 mm to 21 mm size. So accordingly you can come to know when the egg is getting or is released. Plan your sexual relation on and around the day of egg release. Even you come to know that the egg is released, have sex on that day. The egg has a life of 24 hours.

With this information and advice, now you are better equipped to plan for your pregnancy.

You are most welcome to ask any of your doubts; I am available for you, XXXXXXX

Dr. Nishikant Shrotri

---

Brief Answer:
Had viewed the images.

Detailed Answer:
My dear XXXXXXX

I have gone through the images also and have expressed my opinion and views based on both, your images and the Report of Mr. XXXXXXX Oza.

Do you want my opinion or explanation on any specific point, other than what I have already discussed ? If so, please specify clearly. I am at your health service, XXXXXXX

Dr. Nishikant Shrotri

---

Brief Answer:
Be positive

Detailed Answer:
Dear XXXXXXX

So long as the tube is patent and having peristaltic movement, you do not have to worry. It will pick up the egg and transport towards the uterus. Here in XXXXXXX also, I discussed with many of my friends who are infertility consultants. No one is willing to accept the entity of 'sluggish tube' as an abnormality.

Moreover, I have already informed you that any side of tube can pick up egg from any side of the ovary; even from the contralateral side too.

What you feel is probably true. Please do not think negatively; be positive.

Please throw away your stress lest it will hinder egg release and pregnancy. Relax and have your normal marital life.

Dr. Nishikant Shrotri

---