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Peritubal adhesions and infertility
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Fertility & Reproductive Support
Question #19925
199 days ago
510

Peritubal adhesions and infertility

Aliki

Hysterosalpingography report: Uterine cavity in pronounced flexion (upside down), normal shape. Both fallopian tubes were easily visualized, with no evidence of hydrosalpinx. Normal exit of contrast medium into the peritoneal cavity. Small contrast retention in both fimbrial ends due to peritubal adhesions. Could I get pregnant naturally or do I need to have IVF?

Age: 28
Chronic illnesses: No
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Doctors' responses

Hello dear As per clinical history the tubed are open. You have the chances of natural pregnancy . IvF can be an option but it is not mandatory. So as per my suggestion go for natural pregnancy and get below tests shared with gynecologist for better clarity Pelvic USG Serum prolactin Serum tsh Serum ferritin Lh monitoring Semen analysis Regards

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Hello,

Yes, natural pregnancy is still possible because both tubes are open and spill is present.

Peritubal adhesions can reduce fertility but do not automatically mean IVF is required.

Many women conceive naturally or with minimal help.

Stay healthy Thank you

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Peritubal adhesions can sometimes impact fertility, particularly if they’re affecting the fimbrial ends of the fallopian tubes where they need to capture the egg after ovulation. In your case, the report suggests that your fallopian tubes are patent and there’s normal spill of contrast into the peritoneal cavity, which is a positive sign because it usually indicates that the pathway for natural conception might still be open. However, the presence of adhesions at the fimbrial ends could still potentially interfere with the ability of the egg to be successfully captured by the tube.

Before jumping to the conclusion that you need IVF, it might worth exploring a few other less invasive options first. One approach could be to consider trying medication like clomiphene citrate that helps to stimulate ovulation, often used alongside timed intercourse or intrauterine insemination (IUI), especially if other fertility factors such as sperm count and uterine issues are normal. It’s also prudent to review other fertility factors with your healthcare provider, such as age, ovarian reserve, partner’s sperm quality, and overall reproductive health.

Further imaging or a direct procedure like laparoscopy could also be suggested to assess the extent of adhesions and, if appropriate, surgical intervention could be useful in some cases to release them. Consult with a fertility specialist who can provide a more tailored evaluation of your overall reproductive health and advise the best course of action. This can ensure that the treatment plan suits your personal circumstances and enhances the chances of conception, while balancing any concerns or resources you might have in seeking IVF.

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Overall, the HSG findings are reassuring and do not indicate a need for immediate IVF. Both fallopian tubes are open with normal spill of contrast, which means egg and sperm can meet naturally. The small peritubal adhesions noted at the fimbrial ends are mild and external to the tubes, and they do not necessarily prevent ovum pickup or fertilization. A retroflexed (upside-down) uterus is a normal anatomical variant and does not cause infertility. Given your age of 28 and patent tubes, natural conception is very much possible, and trying to conceive naturally (with or without simple treatments like ovulation tracking or induction) is the appropriate first approach. IVF should only be considered later if pregnancy does not occur after an adequate period of trying or if additional infertility factors are identified.

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