HSG Report Showing Uterine Cavity Is Opacified And Advised To Go For Laparoscopy. Need Second Opinion

Posted on Mon, 11 Nov 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 11 Nov 2013 Answered on

Tue, 3 Dec 2013 Last reviewed on

Question : Hello, my HSG report says "uterine cavity is opacified and normal in size. No septae or extrinsic filling defects seen. Fallopian tubes: Both tubes are visualized and are normal in calibre with faint peritoneal spill on the left, no definite spill on the right. Impression: E/o external oblique Contrast artifact seen at mid pelvis. 1. Patent left tube, no definite spill on the right (Suggested laparoscopic correlation) 2. Normal size of uterine cavity. My doctor suggested me to undergo laparoscopy and i need a second opinion on this, please suggest and help. Thanks.

Answered by Dr. Sree Gouri SR (33 minutes later)

Brief Answer: Laparoscopy having diagnostic and therapeutic role Detailed Answer: Hi, Thanks for the query. According to your HSG findings: - Uterus is normal in size and cavity is normal. -Left side fallopian tube is normal. Right side absence of spillage can be due to: - Spasm during doing of HSG. -Some obstruction in the tubes, either due to adhesions or damage. -I think the external oblique contrast artifact they mentioned could be cannula used to inject the XXXXXXX or some intra uterine device. So by doing laparoscopy the patency of the right fallopian tube can be tested. As surgery will be done under anesthesia, the possibility of spasm of tube can be avoided. Injecting the XXXXXXX during surgery can help in removal of minor obstructions. Possibility of adhesions can also be examined and if possible can be removed in same sitting. So depending on the severity of your problem and affordability, you may plan for laparoscopy with your doctor's advice. Hope I have answered your query. I will be available to answer followup queries. If you are satisfied with the answer, please give your review at the end of the discussion. Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sree Gouri SR (5 minutes later)

Hello Dr. Sree Gouri, Thank you for the reply. The mail is written in detail but is that the reason that i am unable to conceive. I have one more question, if my left tube is working fine then why i am unable to get conceived? If laparoscopy is done, will the blocks get cleared and how do we know what is blocking the tubes? Thanks, XXXX

Answered by Dr. Sree Gouri SR (33 minutes later)

Brief Answer: May or may not be the cause Detailed Answer: Hi, Blockage of the right fallopian tube may or may not be the cause for your problem. Usually the ovaries will release the ovum alternatively in monthly menstrual cycles. When one ovary releases the ovum, that side fallopian tube will pick it up generally. So when one side tube is blocked, that will decrease the chances of fertility to 50%. Minimal tissue blocks can be cleared by pushing the XXXXXXX in laparoscopy. This will not apply to major blocks or adhesions. The exact cause of the block may not be diagnosed but during laparoscopy uterine endometrial scrapings can be taken and can sent for histopathological examination. That can help to some extent in finding the cause for the blockage like tuberculosis etc. Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sree Gouri SR (19 minutes later)

Thank you for the detailed explanation. Can i skip this laparoscopy procedure and go directly for IVF as i am already 31, is it suggestible? Will the doctors check for AMH (Anti-Mullerian Hormone) before going to IVF? What is its role and how this will be helpful in IVF. Are there any side effects after laparoscopy and how many days of rest is required? Thank you.

Answered by Dr. Sree Gouri SR (18 hours later)

Brief Answer: You may go for IVF with your doctor's advice Detailed Answer: Hi, •Yes, if your doctor recommends you can directly go for IVF. But here few facts to be considered, that: - IVF is a costly procedure compared with laparoscopy. - IVF is also not having 100% success rate. -Even at the age of 31 years sufficient ovarian reserve is possible. So by taking all these factors into consideration and after discussing with your doctor you can come to one conclusion. •Yes, doctors usually check for Anti-Mullarian hormone levels when planning for IVF. AMH is produced by the ovarian anthral follicles. Normal AMH levels indicate good ovarian reserve. And people with normal AMH levels will have high IVF success rate. •Usually there may not be any major side effects after laparoscopy. Some amount of pain can be there for few weeks. After laparoscopy you can go home on 1st or 2nd postoperative day depending on hospital protocol. Rest for one week is enough and you can do your routine work after one week. Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar