What are the chances of pregnancy when bilateral having fimbrial blockage and PID?
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My wife age is 33. Her hystero laproscopy was done recently for infertility. Both tubes showed bilateral fimbrial blockage. Both fimbrial ends were opened with fimbrioplasty, achiving delayed spill. Ovaries and uterus are normal. Sings of pid seen. Does she has chances of pragnancy. Please advice for treatment.
Posted Tue, 4 Feb 2014 in Infertility Problem
Answered by Dr. Dattaprasad 1 hour later
Brief Answer: Average chance of pregnancy. Detailed Answer: Hi, Welcome to XXXXXXX Chance of pregnancy depends on three things: 1. Sperm count & motility, 2. Patency of tubes, 3. Ovulation. Out of these three husband's semen analysis report appears normal, for ovulation wife has received Siphene (which should induce ovulation in 85-95% of anovulatory women). Regarding third factor, tubes had fimbrial block which was cleared, so as of now they can be considered to be patent. When all three things are fine, chance of pregnancy per cycle varies between 25-33% giving pregnancy in 70% cases in 6 months. One important factor: Tubes opened through laparoscopy generally are less healthy compared to normal & there is chance of re blockage (say in 6-9 months or so). So you have to try with maximum efforts in these 6 months. Second thing, generally siphene cycles generally give lower pregnancy rates (5-25% depending on duration of infertility & previous ovulatory status) than those stimulated with hormone injections. But important advantage is low cost. Third thing, I didn't get why wife was prescribed cabergoline? Was her prolactin level too high? Further treatment depends on answers to following two questions: 1. Were wife's menstrual cycles regular/irregular? What is the frequency (eg. every 28-30days or so). 2. How many months/years you are trying for pregnancy? (Unprotected sexual intercourse). Kindly get back with the answers for further guidance. Awaiting reply. Regards.
Follow-up: What are the chances of pregnancy when bilateral having fimbrial blockage and PID? 37 hours later
Thanks for advice. My wife's cycle is regular with 28-30 days and we are trying unprotected sex for 4 months. Does she has chances of ectopic pragnancy or should be wait and watch? For How many periods does she require to take siphene? Her prolactin level is 45.97 ng/ml. Please advice. Thanks.
Answered by Dr. Dattaprasad 12 minutes later
Brief Answer: Can try naturally. Detailed Answer: Hi, Welcome back. As you are just trying for last 4 months, you can continue trying naturally for 2-3 more months. Other option is to undergo superovulation (making more than one egg with the help of injections) with IUI (Processing husband's semen & putting directly in wife's uterus). Superovulation with IUI will give higher chance of pregnancy, but is little costly (Rs 10000 to 30000/- depending on hospital chosen) and should not be required right now. Regarding chance of ectopic pregnancy, though its true that chance of ectopic might be more than general population (say around 10%), its equally true that there is more chance of having normal intrauterine pregnancy than ectopic (90% chance of normal pregnancy). So you should not worry about ectopic pregnancy right now. Only thing is to ensure adequate follow up during early pregnancy to detect & treat ectopic pregnancy early. Prolactin level of 45.97 ng/ml is not so high to necessitate treatment. You can consult your doctor to stop cabergolin. Regarding need for siphene, as she should be ovulating regularly on her own (with regular cycles you can confirm it by doing serum progesterone on 21st day of menses, day of start of menses is counted as day one), she should not require siphene tablets. So summarizing plan of treatment, my suggestion is, you can try naturally (without medicines) for 2-3months, if not successful go ahead with superovulation with IUI after 2-3monhs. Wish you good health. Regards.