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Dr. Andrew Rynne

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Trying to conceive. HSG test showed normal fallopian tube with free pelvic spill. Chances of pregnancy?

Answered by
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Dr. Dattaprasad

Infertility Specialist

Practicing since :2002

Answered : 673 Questions

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Posted on Mon, 24 Dec 2012 in Infertility Problem
Question: Hi sir
I m XXXXXXX age 34 trying to conceive for last 5 months but am unsuccessful. my doctor HSG test. I took HSG test whose results are
1) Normal uterine cavity
2) Normal Left Fallopian tube with free pelvic spill.
3) Normal Right Fallopian tube with partial spill.
sir now I want to know the condition of Fallopian tubes and my chances of pregnancy
doctor
Answered by Dr. Dattaprasad 56 minutes later
Hi XXXXXXX

Thanks for the query.

For normal conception three things are required:
1. Normal semen analysis
2. Patent tubes (which is confirmed by your HSG)
3. Regular ovulation (often indicated by regular 25-35days menstrual cycle).

I have seen HSG films & they are fine (normal). As the status of other 2 factors is unknown, it would be better if you can more details about your menstrual cycle pattern & husband's pregnancy & guide further.

Also as your age is 34 years, to give exact prognosis it will be nice if you can do an ovarian reserve test like serum AMH & upload the report.

Awaiting your response...

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dattaprasad 22 hours later
Thanks sir for reply. I'm giving some facts for your consideration please.
I have a daughter 5 years old. As desired by your goodself my menstrual cycle pattern is of 25 to 28 days.
Also I m uploading my husband's semen analysis report.
Could you please specify what actually is ovarian reserve test as you mention like serumAMH test and what is done in it and chances of my pregnancy.
Regards,
XXXXXXX
doctor
Answered by Dr. Dattaprasad 4 hours later
Hi XXXXXXX
Thanks for providing the details.
Your menstrual cycle pattern of 25 to 28 days indicates regular ovulation. Also your husband's conception are normal. When all three things are fine, chance of conception is 70% after 6 months & 85-90% after 12 months of trying for pregnancy.
Ovarian reserve test is a test to know capacity of your ovaries to make eggs. The capacity to make eggs can decreases in some women (either due to age: >35 years in infertile women & >37-38 years in normal women, OR due to disease of ovary). Decreased ovarian reserve decreases chances of conception. AMH is a blood test to know ovarian reserve.
As you already have daughter of 5 years (proven fertility), you can skip the test & try for 3-4 months OR if you are very anxious, you can do it from any standard laboratory & upload the result. (Result can take up to one week depending on the laboratory you select).
Just let me know your decision & if you are planning to do AMH, you can upload the result.
Awaiting your response...

Regards


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dattaprasad 20 hours later
Thank sir. Just to bring to your information that 5 cycles of follicle monitoring has been completed and XXXXXXX size of follicle is 24x24 and rupturing took usually takes place between 16 to 18 th day. As you suggest to wait for 3 to 4 months I will definitely undergo the test you suggested. Is the size of follicle ok.
Regards
doctor
Answered by Dr. Dattaprasad 1 hour later
Thanks for the reply.

Maximum Follicle size of 24x24 is normal when you are taking Fertomid.

If follicle is rupturing between 16 & 18th day, your next period should come between 30th & 32nd day. If it is not so, you require good support with medicines like duphastan for 14 days after rupture of follicle.

If you have already taken Fertomid for 5 cycles, there is no point in continuing the same treatment indefinitely. You can take Fertomid for 6 months at a time (and maximum 12 times in lifetime) without causing harmful effects. If you have taken Fertomid for last 5 cycles, it’s better to take treatment with better success rate (like superovulation with injectable medicines & intrauterine insemination). You can discuss the topic with your treating doctor & decide for the best plan.

Hope this answers your query. Let me know if you have other concerns.
If you do not have any clarifications, you can close the discussion and rate the answer.

Wish you good health

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dattaprasad 48 hours later
Thanks Sir, What actually is IntraUterine insemination and how superovulation with injectible medicine is done. Hope you answer this question.

Regards

XXXXXXX
doctor
Answered by Dr. Dattaprasad 24 hours later
Hi,
Intrauterine insemination is concentrating & processing semen to get most motile & healthy sperm & inject directly into your uterus.
Normally you are making one egg per menstrual cycle. With superovulation with injectible medicine you are required to take injectible hormone (FSH) to form more than one eggs (two or three).
When both are combined (to make you suprafertile), your chances of pregnancy increase dramatically (around 20% per cycle). (With fertomid alone chance of pregnancy is just 3-5%).
Superovulation with IUI is relatively cheap & highly effective treatment to achieve fairly good pregnancy rate.

Hope this answers your query. Let me know if you have other concerns.
If you do not have any clarifications, you can close the discussion and rate the answer.

Wish you good health

Regards


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