Please advise regarding my HSG results and my husband's semen analysis.

Question

Hello doctor,

My HSG test report is as follows. Impression: Contrast spill into the peritoneal cavity was not visualized on the left side, however faintly probably seen on the right side. Clinical correlation is suggested for further management. What does this mean?

Answer 1

Hi,

Welcome to icliniq.com.

I have read and understood your problem. (attachment removed to protect patient identity) However, I would like you to answer a few questions so that I can help you better. Did you get a pelvic ultrasound scan done?

Your HSG report says tubes visualized and no dilatation seen, this is good. But the second part mentions contrast spill into the peritoneal cavity was not visualized on the left side, however faintly probably seen on the right side, this may indicate a block in the tubes at their outer end.

If there is block of the tubes at their outer end, then hydrotubation (tubal flushing) can open it. Alternatively, a laparoscopy and fimbriolysis may open it. Blocked tubes are usually caused by Pelvic Inflammatory Disease (PID) due to infection with chlamydia, tuberculosis, and other microbes and also by endometriosis, a condition where there is a collection of menstrual type blood around the uterus, ovaries, and tubes.

If you can send me the image, I can comment better.

Answer 2

Hi,

Welcome back to icliniq.com.

I have seen the reports. (attachment removed to protect patient identity)

Your husband's semen report says motility is low 9+18 and also pus cells 3-4. Does he drink alcohol or smoke? Did he have any exposure to heat or chemicals or any past history of major illness?

He will need to do blood or serum tests like TSH, testosterone, sugar - fasting, prolactin, Hb, TC, DC, and also semen culture and sensitivity. He also has to do an ultrasound of the scrotum.

According to my interpretation of your HSG report, the block appears not at the outer but the inner end of tubes. This is often caused by spasm, and there may not be a true blockage. Next step is laparoscopy, but you may wait till your husband's report becomes normal, which can be improved by medicines.