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Dr. Andrew Rynne

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Suggest treatment for tubal abnormality

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Dr. Bhagyashree.B

OBGYN

Practicing since :2000

Answered : 788 Questions

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Posted on Mon, 18 Aug 2014 in Infertility Problem
Question: Hello Doctor,
I am married from last 3.5 years, and trying for baby. Have gone through required prerequisite tests for both of us. My wife has been go through the test " Hysterosalpingography"( HSG). Below are the findings ( Attaching the report)

1) Uterus shows no filling defects
2)Right fallopian tube shows infundibular hydrosalpinx with the narrowing at the fimbrial end with mild peritoneal spillage
3)left fallopian tube shows a fairy long segment holoinfundilbular hydrosalpinx with narrowing at the fimbria end with very minimal subtle interperitonail spillage.



To give you further history , She had conceived & miscarried it in the 8th week, this was around 2 years back. Am 33 and my wife is 28 years old , Let us know in case any further details are required. What should be our next step.
doctor
Answered by Dr. Bhagyashree.B 34 minutes later
Brief Answer:
antibiotics followed by laparoscopy

Detailed Answer:
Dear member,
Thanks for writing.
The main reason in your wife's case is tubal abnormality. Hydrosalphinx is usually due to infection.
For my patients I would suggest Doxycycline 100mg twice a day for 2 weeks along with metronidazole 400 mg thrice a day for a week.Your treating doctor will know about this.
It will be good to assess tubes directly after antibiotics by laparoscopic method. Here by a keyhole in the abdominal wall the uterus and tubes are visualized directly.
Hysterosalphingogram cannot give all information.
I would recommend you to undergo laparoscopic assessment and treatment for fallopian tubes.after which it can be decided whether the tubes are ok or she needs IVF(In vitro fertilisation)
Please write back if you have any questions
Thanks
Dr Bhagyashree

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Follow up: Dr. Bhagyashree.B 17 minutes later
Dear Doctor ,
Thank you for the answer, what could be the approximate cost for the laparoscopic assessment and treatment for fallopian tubes in XXXXXXX ( Bangalore).

Is it necessary to do the laproscopic assement & treatment even in case we decide to go for IVF directly?

Regards
XX
doctor
Answered by Dr. Bhagyashree.B 1 hour later
Brief Answer:
detailed answer below

Detailed Answer:
Dear member,
Thanks for writing.
The hydrosalphinx needs to be treated. Even if you are considering IVF.
The hydrosalphinx has a collection of fluid and pus which may lead to inflammation of the tubes and Uterus and may increase chances of IVF failure.so antibiotics need to be given.

The laparoscopic evaluation is not requiredif you are going for IVF though most doctors recommend a hysteroscopy before ivf.
The cost depends on different hospitals.
Should be around 40,000-50,000.
Thanks
Dr Bhagyashree


Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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