Monday, July 04, 2011

How does your doctor interpret your HSG ?


An HSG ( hysterosalpingogram, X-ray of the uterus and tubes,  is one of the commonest tests performed for infertile women , to confirm their uterine cavity is normal and their fallopian tubes are open.
How does the doctor interpret your HSG films ?
Sometimes, the films are of such poor quality , that we cannot make any sense of them. This maybe because the procedure was not done properly; or because the film was overexposed or under-exposed. Sometimes, the patient moves during the procedure, as a result of which the images may be blurred or out of focus.
When this happens, this is a major shame, because we are then forced to repeat the study. I hate doing this, because I know the HSG can be quite painful !
This is why it’s best to do the HSG in a clinic which has a lot of experience doing HSGs; and which uses an image intensifier , to make sure they get good quality images.
A good HSG study should take multiple images, including a delayed film, to ensure that the doctor can track the spread of dye from the fallopian tubes into the abdominal cavity. Sadly, sometimes some X-ray clinics take shortcuts ( to save money ?) and do not take a delayed film. This can be very frustrating, because then we cannot reliably answer the key question the HSG is designed for – are the tubes open or closed ?
If the plates are technically of good quality, then we look at the medical information they provide. The dye first fills the uterine cavity, which appears as a triangle. It’s important to carefully look at the cervical canal also, because sometimes a long and narrow cervical canal suggests cervical stenosis, which may make an embryo transfer technically difficult.
The uterine cavity may have filling defects within them. Often, these are air bubbles ( which appears as spherical lucencies which move as more dye is injected) , and can be safely ignored. Sometimes, the defects allow the doctor to make a diagnosis of polyps; submucous fibroids; or intrauterine adhesions.
Uterine cavities come in many shapes and sizes and many fertile women have small uterine cavities ; or cavities with curved walls . However, when some doctors see a small uterine cavity, or one which has a curved shape in an infertile woman, they diagnose this to be the cause of the infertility , and advise a “ hysteroscopic metroplasty, to “increase the size of the cavity” , claiming that this procedure increases the chances of the embryo implanting. This is unnecessary meddlesome surgery, which can actually create adhesions and reduce your fertility, so please do not do this. An embryo is microscopic, and can implant in any healthy uterine cavity , no matter how small it is !
The doctor then checks if the dye has entered the tubes are not. The tubes appear as 2 fine lines arising from the upper and outer ends of the triangle ( the cornu of the uterus) . In a normal woman, both the tubes will fill with the dye which will then spill out of the outer ( fimbrial) end of the tubes into the peritoneal cavity, where they will appear as a smudge. Normal tubes are said to show normal fill and spill.
If the tubes are blocked, they will not allow the dye to pass through them. This block should be at the cornual end of the tube; in its isthmic or mid-tubal segment; or its terminal end ( when it is called a hydrosalpinx)
Remember that the dye injected during the HSG only outlines the inside of the cavity and tubes – we cannot see the ovaries or endometriosis or peritubal adhesions with a HSG.
If the tube shows normal fill and spill, this just means that it is anatomically normal – this does not mean that the tubes function properly. Sadly, there is still not test for tubal function; but for someone with normal patent tubes, it’s quite reasonable to assume that the tubes work properly . Sometimes the radiologist describes the tubes as being “beaded”. If it’s open, it’s still best to assume that this is an anatomic variant and that the tube works properly.
If one tube is blocked and the other is open, this is usually not a cause for concern, as one normal fallopian tube is enough for making a baby ( though the time taken to conceive may be increased in these women).
If both the tubes are blocked, then further management will depend upon where the block is. If it’s a fimbrial block, then there is no way of repairing damaged fallopian tubes, as they cannot function normally even after surgery, since their inner lining ( the cilia) has been damaged. IVF would be the best option.
Some doctors remove the hydrosalpinx prior to IVF because they believe the hydrosaplpinx fluid is embryotoxic. We do not recommend this and you can read why at www.drmalpani.com/hydrosalpinx.htm
If it’s a cornual block, this could be because of a spasm; or because of a mucus plug. A simple treatment option is called FTR and you can read more about this at http://www.drmalpani.com/ftr_fallopian_tubal_recanalisation.htm
Some doctors advise that patients have a laparoscopy if their tubes are blocked, so they can find out more about the block and what has caused it. We do not advise this, as this does not change your treatment options at all ! Read more at http://www.drmalpani.com/laparoscopy-and-infertility.htm
Need help making sense of your treatment options if your tubes are blocked ? I’ll be happy to provide a free second opinion if you send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm !
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75 comments:

  1. Anonymous11:43 AM

    HSG report shows tubes are open, is it true all the time?

    ReplyDelete
    Replies
    1. Yes, a HSG is reliable

      Dr Aniruddha Malpani
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !


      Watch our infertility cartoon film at http://www.ivfindia.com

      You can add a google review for us at https://plus.google.com/102706636605134081909/about


      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !


      Delete
  2. Anonymous11:38 AM

    hi, i had an has done in 2014, nd the report concluded a patent left fallopian tube, normal uterine cavity, and pelvic adhesion . please can you explain what this mean in terms of my fertility i have been trying for two yrs now

    ReplyDelete
    Replies
    1. Do a complete workup before starting treatment haphazardly.

      You need to do ALL the following simple medical tests:

      semen analysis for your husband ( to check his sperm count and motility).
      Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b

      blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.

      HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm
      your fallopian tubes are open);

      The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture

      Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.

      Please send me all the results together, rather than piecemeal, so I can interpret them intelligently

      With these test results, we can determine what medical problems are causing your
      infertility.

      If there is a problem, then we can treat it !

      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      We look forward to helping you to have a baby !

      Regards,

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com

      Delete
  3. Hello. I have visited my doctor and during the ultrasound he said he saw something and said it could be a polyp (1.4cm). He asked for an hsg. I had an hsg done and both Fallopian tubes were open, the report said "a well defined subtle small Lucency is seen in the upper portion of the uterine cavity, possibly an air bubble. Other entities (polyp, submucous fibroids...) should be excluded.)
    However, and since the location of the "subtle small lucency" did not change in all hsg ultrasound shots, so my doctor said that to be sure I should have a Hysteroscopy done just I case, and it could turn out to be nothing.
    Should I do that or not. I mean does having a polyp decrease my chances of getting pregnant? I'm 33 and have been ttc for almost 7 months

    ReplyDelete
    Replies
    1. A HSG is not a good way of making a diagnosis of a polyp.

      I agree you need a hysteroscopy to remove the polyp

      Delete
  4. I had a hsg and the doctor showed me one picture afterwards and told me there was no spillage from either tube.,but my report said something different so now I'm confused.this is my report FINDINGS:
    Uterus and bilateral fallopian tubes appear normal. Fallopian tubes
    are patent bilaterally with bilateral spill. Tubal dilatation on the
    left noted. No focal abnormality identified.

    IMPRESSION:
    Bilateral fallopian tube patency with tubal dilatation on the left.

    ReplyDelete
    Replies
    1. A good X-ray clinic should take at least 3 plates, including a delayed film. A single film is never acceptable. Read more at www.drmalpani.com/knowledge-center/articles/hcg

      Delete
  5. They took 6 pictures but only showed my the first one they took.

    ReplyDelete
  6. Anonymous6:50 PM

    Hi Aniruddha,

    I had my hsg recently.

    Report says as below:
    Multiple air bubbles in uterine cavity
    Both fallopian tubes are visualised.
    Spillage is seen bilaterally into the pelvic cavity.

    Could you please let me know if the report says everything is fine ?

    Thank you

    ReplyDelete
    Replies
    1. Good, this is a normal HSG

      Dr Aniruddha Malpani
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !


      Watch our infertility cartoon film at http://www.ivfindia.com

      You can add a google review for us at https://plus.google.com/102706636605134081909/about


      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !


      Delete
  7. Anonymous6:15 AM

    Thanks a lot doctor. I consulted few of the doctors and they had different opinions. Few say it's blocked and few say it's not. As I was googling I came through this blog and thought you were the right person.

    Thanks a lot ☺

    ReplyDelete
    Replies
    1. Happy to have been of help. Air bubbles are just an artifact and can be ignored

      Delete
  8. My hsg report say that there's no opacification in left tube and no opacification in right tube what does this mean

    ReplyDelete
    Replies

    1. This means both your tubes are blocked at the cornual end

      Read more at http://www.drmalpani.com/knowledge-center/articles/blocked-fallopian-tubes

      I need more information.

      Could you please send me your medical details by filling in the form at http://www.drmalpani.com/free-second-opinion
      so I can guide you better ?

      Taking treatment at a world-class clinic will maximize your chances of success and give you peace of mind you did your best !

      We look forward to helping you to have a baby !

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba

      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com


      Delete
  9. Hello sir,I had my hsg test done..The report has shown no blockage of tubes but uterus was not imaged in the x-ray plates..The x-ray plates shows normal fallopian tubes with proper spillage..I cannot understand why the uterus remained unassesd as mentioned in the report.Please help me to know what this actually means?

    ReplyDelete
    Replies
    1. They took the images too late. By the time they took the X-rays, the dye had already left the uterine cavity and entered the fallopian tubes. If your uterine cavity is normal on the vaginal ultrasound scan then you don't need to worry

      Delete
  10. Hello
    My HSG showed both tubes well opacified delay in spillage narrowing of fallopian tube
    Is this normal

    ReplyDelete
    Replies
    1. Good, this is a normal report, which means your fallopian tubes are open

      Do a complete workup before starting treatment haphazardly.

      You need to do ALL the following simple medical tests:

      semen analysis for your husband ( to check his sperm count and motility).
      Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b

      blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.

      The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture

      Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.

      Please send me all the results together, rather than piecemeal, so I can interpret them intelligently

      With these test results, we can determine what medical problems are causing your
      infertility.

      If there is a problem, then we can treat it !

      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      We look forward to helping you to have a baby !

      Regards,

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com

      Delete
  11. I had hsg done last Wednesday my report says: no filling defects are seen in the uterine cavity. Right fallopian tube appears to be of normal caliber. There is contrast spillage from the fimbrial end of the right tube. Left tube is not optimally visualized. There is a loculated fluid collection in the left adnexa. Right tube is not dilated and appears to be patent.

    Does this mean my left is closed and my right tube is open?

    ReplyDelete
  12. I had hsg done last Wednesday my report says no filling defects are seen in the uterine cavity. Right fallopian tube appears to be of normal caliber.there is contrast spillage from the fimbrial end of the right tube. Left tube is not optimally visualized. There is a loculated fluid collection in the left adnexa. Right tube is not dialed and is patent.

    ReplyDelete
    Replies
    1. Yes, this means your left may have a cornual block and your right is open. One normal tube is enough for normal fertility

      Do a complete workup before starting treatment haphazardly.

      You need to do ALL the following simple medical tests:

      semen analysis for your husband ( to check his sperm count and motility).
      Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b

      blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.

      The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture

      Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.

      Please send me all the results together, rather than piecemeal, so I can interpret them intelligently

      With these test results, we can determine what medical problems are causing your
      infertility.

      If there is a problem, then we can treat it !

      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      We look forward to helping you to have a baby !

      Regards,

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com

      Delete
  13. I did an hsg and vagina scan. It showed that my uterus has some defects that can but be ascertain if it's fibroid or not. How can I go about the treatment?

    ReplyDelete
  14. I recently had a hsg procedure and a vaginal ultrasound. It showed both tubes are opacified and are normal in outline and caliber. Bilateral patent tube.
    My hormonal assay showed that
    fSH is 14.1mUI/ml
    LH is 7.3mUI/mI
    Estradiol is 17.3pg/ml
    Prolatin is 29ng/ml
    My progesterone test isn't out yet.
    The gynaecologist said there are some defects in my uterus that could be indicative of fibroid but he isn't sure.
    Please what do I do as I have never been pregnant all my life and I have been TTC for over 6months Now.

    ReplyDelete
    Replies
    1. If the uterine cavity is normal on the HSG, you don't need to worry about the fibroids.

      Intramural fibroids ( in the wall of the uterus) do not need to be removed as they do not affect embryo implantation.
      You can read more about this at www.drmalpani.com/knowledge-center/articles/fibroids-and-infertility

      Only submucous fibroids ( which are in the uterine cavity) need to be removed. These can be best removed with an
      operative hysteroscopy ( www.drmalpani.com/knowledge-center/articles/hysteroscopy) to normalise the uterine cavity.

      I am concerned about your high FSH:LH ratio.
      Read more at http://www.drmalpani.com/knowledge-center/articles/highfsh

      This suggests you may have poor ovarian reserve .
      You can read more about this at http://www.drmalpani.com/knowledge-center/the-infertile-woman/oopause

      We look forward to helping you to have a baby !

      Delete
  15. Anonymous7:53 AM

    My hsg report says my right tube is patent and left tube spillage is not normal..then on 10,12 nd 14 day I took up follicular scan which showed follicle on left ovary. Can u recheck my x-ray and suggest us if my tubes are patent

    ReplyDelete
    Replies
    1. Sure - please email me the image.My email is info@drmalpani.com

      Dr Aniruddha Malpani
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !


      Watch our infertility cartoon film at http://www.ivfindia.com

      Please add a google review for us at http://bit.ly/2tN1wdb


      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !


      Delete
  16. Anonymous6:44 PM

    Hello. What are the options available on bilateral tubal blockage?

    ReplyDelete
    Replies
    1. I need more information to be able to provide you with intelligent advise.

      Where are your tubes locked ? Cornual end ? Fimbrial end ?

      Delete
  17. hsg results was water soluble contrast was introduced into the uterine cavity aseptically.
    the uterine is normal in size,shape and outline. no filling defects seen.
    both fallopian tubes are well outlined with loculated spill bilaterally
    there is no free peritoneal spill

    ReplyDelete
  18. No spillage found, dye doesn't pass thru both fallopian tubes, what should I do next? Is there any chance of repairing and conceiving

    ReplyDelete
  19. Where will be my blockage? Cornual, fimbrial?

    ReplyDelete
    Replies
    1. This means you have a cornual block.

      One option is FTR
      Read more at http://www.drmalpani.com/knowledge-center/articles/ftr-fallopian-tubal-recanalisation

      Delete
  20. Berry9:53 PM

    Hsg result proves bilateral patent tubes left hydrosaphix and pelvic adhesions. Please what does it mean.please

    ReplyDelete
    Replies
    1. This means that this is a poor quality report - radiologists should not draw clinical conclusions based on black and white images.
      No one can see adhesions on a HSG !

      Delete
  21. Anonymous1:45 PM

    Did my hsg...Report shows both fallopian tubes are filling and appear to be normal in course and caliber....both show good and prompt peritoneal spill of contrast...however distal ends are convoluted and pooling of contrast is seen at this site suggesting peritubal adhesions....uterine cavity is slightly irregular in outline....no gross filling defect or any synechae shown...conclusion is suspected bilateral peritubular adhesions otherwise patent tubes...what does this mean?

    ReplyDelete
    Replies
    1. This is a normal report

      Radiologist reports should not try to draw clinical conclusions, because these are often wrong. Over-interpreting an image can create a lot of needless distress

      Delete
    2. Anonymous3:34 PM

      Thnku Doc...i am relieved on hearing that my reportis normal...actually we are trying for a baby from past two years...all investigations are normal for me as well as my husband....dont know what is wrong��

      Delete
  22. Hello sir I had an HSG test and my results shows that the uterine cavity appears normal, both tubes have been outlined normal in caliber and there is free spillageshown bilaterally am I normal and after the HSG I went back home and I started having bad cramping with took about 1 hour then stopped after taking the medication why was I having the sharp pains please I need your help

    ReplyDelete
  23. 1.The endometrial cavity is normal in shape and wall kutline 2. Abrupt termination of fallopian tube is noted approximately 2 cm distal to cornua on left side. 3. Right side tube is normal 4. Free peritoneal spill is noted on the right side. impression left mid tubal blockage,
    What should be the next step

    ReplyDelete
  24. This means your right tube is open
    One normal tube is enough for normal fertility

    Do a complete workup before starting treatment haphazardly.

    You need to do ALL the following simple medical tests:

    semen analysis for your husband ( to check his sperm count and motility).
    Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b

    blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.

    vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture

    Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.

    Please send me all the results together, rather than piecemeal, so I can interpret them intelligently

    With these test results, we can determine what medical problems are causing your
    infertility.

    If there is a problem, then we can treat it !

    Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

    You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

    We look forward to helping you to have a baby !

    Regards,

    Dr Aniruddha Malpani, MD
    Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
    Mumbai 400 005. India

    Clinic Mobile: 9867441589

    Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

    Helping you to build your family !

    You can add a google review for us at https://plus.google.com/102706636605134081909/about

    My Facebook page is at https://www.facebook.com/aniruddha.malpani

    You can follow me on twitter at https://twitter.com/drmalpani

    Watch our infertility cartoon film at http://www.ivfindia.com

    Read our book, How to Have a Baby - A Guide for the Infertile Couple,
    online at www.DrMalpani.com !

    Read my blog about improving the doctor-patient
    relationship at http://blog.drmalpani.com

    ReplyDelete
  25. Hello Sir....

    My Doctor said that your HSG report is positive....what does it mean....tubes are blocked or open???

    ReplyDelete
    Replies
    1. Hard to say - a good doctor will share more information with his patient !

      Please send me the detailed test results and medical reports . You can scan them in as a single Word file and email them to me at info@drmalpani.com

      Delete
  26. Hi I took my hsg test yesterday but my doc did not provide any reports or observations. Only provided observations saying both tubes are not normal and uterus shape is also different and asking to take laparoscopy to see clear picture of the shape of tube and uterus. Please help.

    ReplyDelete
    Replies
    1. Please find a better doctor ! This is bad advice he is giving you

      He has to give you your HSG film and the reports - these are legally yours !

      We look forward to helping you to have a baby !

      Delete
  27. Hello! Recently had my hsg and during my dr said the left tube was a little slower but ended up emptying, however the written report shows the following:

    endometrial cavity is normal.

    There is prompt filling of the proximal portion of the fallopian tubes bilaterally. There is dumbbell-shaped dilatation of the distal right fallopian tube, without prompt peritoneal spill of contrast, rather pooling of contrast around the distal dilated ampullary region.
    The left fallopian tube is normal in appearance with free peritoneal spill noted.
    Post images show free contrast within the peritoneal cavity.

    IMPRESSION:Impression:
    Normal patent left fallopian tube.
    Abnormal appearance of the right fallopian tube, with dumbbell-like dilatation of the distal aspect, without free peritoneal spill. Abnormal endometrial cavity..

    ReplyDelete
    Replies
    1. Your left tube is normal, and one normal tube is enough for normal fertility

      The right has a hydrosalpinx, but you don't need to worry about this

      We look forward to helping you to have a baby !

      Delete
  28. Anonymous1:01 PM

    failed two Iui husband has slow moving sperm too.did laparoscopy and dye yesterday and finding great uterus accute retroverted. dye test -bilateral fill and very slow spill.please advice

    ReplyDelete
    Replies
    1. If 2 IUIs have failed, and your husband has poor sperm motility, then IVF/ICSI would be your best option

      You can download it free at
      www.slideshare.net/malpani/ivf-comic-book

      We look forward to helping you to have a baby !

      Delete
  29. Doc, you are doing a great job.kindly help interprete
    Following retrograde introduction of contrast,the cervical canal,uterine lining and fallopian tube are outlined
    Most of the cervical canal are taken up by canula however it is normal in calibre and outline.uterine cavity shows some widening? due to uetrine myoma however it shows regular outline.
    Both fallopian tubes are Normal in calibre ad outline and show free pentineo spillage.
    Conclusion; bilateral patent fallopian tube

    ReplyDelete
    Replies
    1. Good, your tubes are open

      Your uterine cavity seems normal, but you should do a vaginal ultrasound scan to confirm there is no myoma/ fibroid

      We look forward to helping you to have a baby !

      Delete
  30. Anonymous3:33 PM

    My report says no intraperitoneal spillage of contrast is bilaterally.
    Bilateral cornual block. Can you please help me understand?

    ReplyDelete
    Replies
    1. Read more at http://www.drmalpani.com/knowledge-center/articles/blocked-fallopian-tubes

      One option is FTR. Read more at http://www.drmalpani.com/knowledge-center/articles/ftr-fallopian-tubal-recanalisation

      If this fails, then consider IVF

      We look forward to helping you to have a baby !

      Delete
  31. Good day

    Please help, had an HSG yesterday and received the following findings: not sure how to interpret them.

    Bilateral Hydrosalpinx, more prominent on the left with obstruction of the fallopian tube on the left.
    Spillage of contrast on the right
    Uterine cavity within normal limits
    No evidence of filling defects or synechiae noted.

    ReplyDelete
    Replies
    1. The cavity is normal; the left tube is blocked; and the right tube is normal
      One normal tube is enough for normal fertility , so please don't worry about this !

      Do a complete workup before starting treatment haphazardly.

      You need to do ALL the following simple medical tests:

      semen analysis for your husband ( to check his sperm count and motility).
      Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b

      blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.

      HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm
      your fallopian tubes are open);

      The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture

      Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.

      Please send me all the results together, rather than piecemeal, so I can interpret them intelligently

      With these test results, we can determine what medical problems are causing your
      infertility.

      If there is a problem, then we can treat it !

      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      We look forward to helping you to have a baby !

      Regards,

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com

      Delete
  32. Good day doctor,

    My doctor said HSG test came out normal, but technician states this comment on his report. What does this mean?THERE IS SUGGESTION OF A STENOTIC CHANGES IN THE CERVIX. Thank you!

    ReplyDelete
    Replies
    1. Dear Melissa,

      This is of no clinical importance. It will not affect your fertility, so please ignore this

      Dr Aniruddha Malpani
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !


      Watch our infertility cartoon film at http://www.ivfindia.com

      Please add a google review for us at http://bit.ly/2tN1wdb


      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !


      Delete
    2. Yesterday,I got my XRay report on HSG...Can you please tell me is it normal or there may be some defect.

      - On HSG, uterine cavity is outluned with contrast. It shows normal surface contour. A linear filling defect due to synechiae formation is seen in its lumen.
      - Both the fallopian tubes are outlined with contrast.
      - Peritoneal spill is seen on both sides.

      Delete
    3. Dear Sunaina,

      Good, your tubes are normal

      There seems to be a filling defect in your cavity. This could be because of an adhesion.

      Your next step is a hysteroscopy ( www.drmalpani.com/knowledge-center/articles/hysteroscopy) to check the uterine cavity and remove the intrauterine adhesion.

      Dr Aniruddha Malpani
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !


      Watch our infertility cartoon film at http://www.ivfindia.com

      Please add a google review for us at http://bit.ly/2tN1wdb


      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !


      Delete
  33. Hsg after period results; the endometrial cavity is opacified and appear normal. There is flow of the contrast into both Fallopian tubes. There is spillage of the contrast in the peritoneum bilaterally. IMPRESSION Essentially normal hysterosalpingogram, patent Fallopian tubes.

    ReplyDelete
    Replies
    1. Good, this is a normal report

      Do a complete workup before starting treatment haphazardly.

      You need to do ALL the following simple medical tests:

      semen analysis for your husband ( to check his sperm count and motility).
      Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b

      blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.

      HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm
      your fallopian tubes are open);

      The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture

      Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me at info@drmalpani.com

      Please send me all the results together, rather than piecemeal, so I can interpret them intelligently

      With these test results, we can determine what medical problems are causing your
      infertility.

      If there is a problem, then we can treat it !

      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      We look forward to helping you to have a baby !

      Regards,

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com

      Delete
  34. Melainie9:42 AM

    hi doc. i don't have any knowledge about HSG. so i watch and read articles or even discussion regarding HSG. i undergo 3 examination including HSG, first ultrasound and TVS, but the result of first two i think it's normal based on my understanding, but now i went to hospital to get the result of my HSG. i really don't understand at all, all i know is my ovaries is not good as i expected. please please evaluate this statement as my result of HSG



    ...HYSTEROSALPINGOGRAPHY SHOWS:

    - WELL OPACIFIED UTERINE CAVITY WITH NORMAL POSITION
    - SMALL FAINT FILLING DEFECT IN UTERUS NOTED IN EARLY FILLING PHASE. (Ser/Img: 1/2)
    - FILLING OF CONTRAST MEDIUM IN PROXIMAL BILATERAL FALLOPIAN TUBES, WITH OUT SPILLAGE INTO THE PERITONEAL CAVITY NOTED BILATERALLY.
    - WE STOPPED THE PROCEDURE DUE TO HIGH PRESSUR


    IMPRESSION:

    - BILATERAL FALLOPIAN TUBES OBSTRUCTION
    - SUSPECT INTRAUTERINE LESION SYCH AS POLYP. DDX: MUCOSAL FOLD




    Please Doc, make this easy for me to understand. Thank you.

    ReplyDelete
    Replies
    1. Dear Melanie,

      This means you have tubal factor infertility because of a dsital tubal block. You can read more about this at www.drmalpani.com/knowledge-center/articles/blockedtubes

      I am sorry there is no way of repairing damaged fallopian tubes, as they cannot function normally
      even after surgery, since their inner lining ( the cilia) has been damaged.

      I agree that IVF would be your best treatment option
      as it would maximise your chances of conceiving quickly.

      Treatment takes about 20 days. Should I send you the treatment plan ?

      I need more information to be able to provide you with intelligent advice.

      Could you please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you better?

      You can read about more about how we take care of our patients at http://www.drmalpani.com/ivf-treatment-at-malpani-ivf-clinic.htm

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !


      We look forward to helping you to have a baby !

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com

      Delete
  35. Recently did an HSG and the results were
    Both tubes were imaged and showed bilateral fimbrial adhesion
    There is no spil of contrast medium in the peritoneal cavity
    The endometrial cavity is normal
    The radiological findings are consistent to bilateral fimbrial adhesion
    IMPRESSION: bilateral fimbrial adhesion

    ReplyDelete
  36. Hi Doc,kindly help shed light on my Semen analysis.
    Time examined... 7mins after semen was produced.
    Volume 2.5MLS(normal range 1.5 to 10ML)
    actively motile 35%, sluggishly motile 5%,dead on examination 60%

    ReplyDelete
    Replies
    1. I need more information to be able to provide you with intelligent advise.

      I need more information to be able to provide you with intelligent advise.

      What's your sperm count ( million per ml) ? sperm motility ( percentage) ? grade of motility ? morphology ?

      You can see what a sperm test report should look like at
      http://www.drmalpani.com/knowledge-center/resources/book/chapter4b

      Can you please scan in your report and send it to me ?

      We look forward to helping you to have a baby !

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com

      Delete
  37. Please I don't understand this result. It says:
    * A moderate capacity uterus was opacified and shows regular outline
    *the right fallopian tube was opacified but there was rounding off of contrast at the left cornum
    *the delayed film shows inadequate pelvic clearance of contrast

    ReplyDelete
    Replies
    1. This is a normal report, though the reporting is of poor quality

      Do a complete workup before starting treatment haphazardly.

      You need to do ALL the following simple medical tests:

      semen analysis for your husband ( to check his sperm count and motility).
      Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b

      blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.

      HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm
      your fallopian tubes are open);

      The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture

      Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me at info@drmalpani.com

      Please send me all the results together, rather than piecemeal, so I can interpret them intelligently

      With these test results, we can determine what medical problems are causing your
      infertility.

      If there is a problem, then we can treat it !

      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      We look forward to helping you to have a baby !

      Regards,

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com

      Delete
    2. margaret
      hi doc please any herbal medicine to unblock tubes
      please advice
      thanks doc



      Delete
  38. Anonymous8:14 PM

    Hello doctor...
    My hsg report says-
    Normal uterine cavity. Both tubes visualized-left tube faintly visualized. Free spill seen on either side.
    Please help me understand this. Thank you.

    ReplyDelete
    Replies
    1. Anonymous12:51 AM

      Please doctor answer this query of mine...im under too much stress ...plz reply

      Delete
    2. Good, this is a normal report

      Do a complete workup before starting treatment haphazardly.

      You need to do ALL the following simple medical tests:

      semen analysis for your husband ( to check his sperm count and motility).
      Read more at http://www.drmalpani.com/knowledge-center/resources/book/chapter4b

      blood tests for you for the following reproductive hormones - FSH ( follicle-stimulating hormone),LH ( luteinising hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.

      HSG ( hysterosalpingogram, X-ray of the uterus and tubes, http://www.drmalpani.com/knowledge-center/articles/hysterosalpingogram) on Day 8 of your cycle ( to confirm
      your fallopian tubes are open);

      The vaginal ultrasound scan on Day 10-11 should check for the following. a. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture

      Please send me ALL the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me at info@drmalpani.com

      Please send me all the results together, rather than piecemeal, so I can interpret them intelligently

      With these test results, we can determine what medical problems are causing your
      infertility.

      If there is a problem, then we can treat it !

      Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

      You can talk to some of our patients by email at http://www.drmalpani.com/success-stories.htm

      We look forward to helping you to have a baby !

      Regards,

      Dr Aniruddha Malpani, MD
      Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
      Mumbai 400 005. India

      Clinic Mobile: 9867441589

      Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

      Helping you to build your family !

      You can add a google review for us at https://plus.google.com/102706636605134081909/about

      My Facebook page is at https://www.facebook.com/aniruddha.malpani

      You can follow me on twitter at https://twitter.com/drmalpani

      Watch our infertility cartoon film at http://www.ivfindia.com

      Read our book, How to Have a Baby - A Guide for the Infertile Couple,
      online at www.DrMalpani.com !

      Read my blog about improving the doctor-patient
      relationship at http://blog.drmalpani.com

      Delete
  39. Anonymous6:23 PM

    Thank you so much doctor..!

    ReplyDelete
  40. Anonymous11:09 PM

    My hsg report said 1)bilateral patent tubes
    2) bilateral terminal dilatation
    Can u plz explain?

    ReplyDelete
  41. Anonymous3:59 PM

    Normal radiological findings

    The cervical canal is normal

    A persistent oval shaped filling defect is seen in the lower uterine region probably due to fibroid nodule.

    Similar filling defect in the upper region that is not persistent are air bubbles.

    The uterine carvity is normal in size.

    Both fallopian tubes are not outlined.

    Impression:
    Bilateral tubal occlusion.

    Doctor do I have hope at All?

    ReplyDelete

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