HSG question


Q: Hi, I was given this report from a HSG test. Could you please tell me what this means?

Retro flexed uterine cavity, normal patency and contrast spill into the peritoneum left was demonstrated, faint whisp of contrast was seen in the proximal right fallopian tube. Contrast was not confidently identified beyond this. No definite contrast spill was seen on the right side of the pelvic perenial cavity.

Left fallopian tube faint contrast line outlining the proximal right fallopian tube was seen but no contrast opacifleation beyond this. No definite spill of contrast into the peritoneum on the right side was demonstrated and therefore right tubal patency cannot be confirmed

Symptoms:  extremely irregular periods. Also been diagnosed with low ovarian reserve.

A:   HSG or hysterogram is done primarily for tubal patency testing. Whereas your left tube has shown a free spill of dye and is therefore patent, the right one seems to have a proximal tube occlusion. This means that there is an obstruction at the uterine end of the tube. The chances of conceiving with one tube patent are reduced by 50 percent roughly but nevertheless even natural conception is possible.
HSG as you may have experienced is basically done by injecting a radio-opaque dye into the uterus. Sometimes there may be a spasmodic reaction in the tubes during dye instillation that may show up as a blockage. It is always a good idea to verify results with a hystero-laparoscopic examination. This basically a key-hole surgery that involves using a telescope like device inserted through your belly button to examine your tubes and uterus. If there is a proximal tubal occlusion, the tube can be opened utilizing a small guide wire and a catheter inserted through the cervix and guided into the tube. This is called as tubal cannulation procedure.
Discuss the HSG results with your OBGYN or fertility medicine specialist with an open mind. Learn about the various options you have before you take any decision.

Comments / Follow Ups

Patient: Thank you very much for your reply! As I said I wasn't really given much feedback on this test. I was worried it might be indicating a hydrosalphinx! My AMH was extremely low so we are looking to use either egg or embryo donation and I've been told that a hgydrosalphinx can greatly reduce the chances of success! Again, thank you so much, you have really put my mind at ease!

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