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Peritubal adhesions and infertility
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Fertility & Reproductive Support
Question #19925
103 days ago
262

Peritubal adhesions and infertility - #19925

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

Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
102 days ago
5

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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Dr. Arsha K Isac
I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.
102 days ago
5

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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Dr. Shayeque Reza
I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.
103 days ago
5

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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