Hi, I understand your concern. HSG is an investigation to test patency of fallopian tubes which have important part to play in conception. It is stated in your report that the peritoneal spillage is loculated in para adnexal region, which may be due to adhesions. The report indicates that though the tube is patent, the passage of contrast ( in test) / ovum in to uterine cavity,after ovulation, is not free due to adhesions between surrounding organs. * this indicates investigations for cause of adhesions( tuberculosis/ pelvic inflammation)& removal of the same may be needed for normal conception.. OR -use of test tube baby may be needed in case of both tubes involvement. Thanks.