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Q. What does bilateral hydrosalpinx mean?

Answered by
Dr. R Balakrishnan Menon
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 01, 2017 and last reviewed on: Oct 07, 2021

Hi doctor,

My HSG report says bilateral hydrosalpinx noted with a free peritoneal spill on the left side. What does this mean? Can I conceive normally? If yes, then how? I have hypothyroidism, which is under control. I take Eltroxin 100 mcg and 75 mcg on alternate days. Please help.

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Hi,

Welcome to icliniq.com.

How are you doing? I have seen your report (attachment removed to protect patient identity).

  • In HSG (hysterosalpingogram), only the right tube looks dilated showing no spill of dye. But the left tube is tortuous and shows the spill of dye very well.
  • Let me explain, the tube has openings on both ends, one into the uterus and other into the peritoneal cavity, through which the egg has to enter. Now when the ends of tube get blocked by adhesions or any trauma or mass, then the discharge will get collected in the tube to form hydrosalpinx. If there is a free flow of dye, it means the tube is open into the peritoneal cavity, so I do not think there is hydrosalpinx on the left side.
  • No one can say it definitely on HSG, the only method to confirm is by a laparoscopy. But, hoping the tube is open on at least one side, you should go ahead and try for pregnancy, if lucky, you should see a positive outcome in 5 to 6 months.
  • If not successful, then the option left is IVF (in vitro fertilization), where tubes are not needed. Get a hysteroscopy, that is, laparoscopy to confirm and open the block and clear the hydrosalpinx.
  • This is not a full proof treatment, as once damaged, the tubal integrity cannot be completely regained. So, it may stay blocked or if the embryo comes through, it can get stuck and form a tubal ectopic pregnancy. The tube is not just like a bridge, which transports the sperm and egg to the embryo. It has lot more roles of nourishing the embryo and moving it on.
  • So, I would suggest to go ahead and try for pregnancy normally for 5 to 6 months, Hope you do not need any further intervention.

Hope I have clarified your query, do write back. All the best.

For more information consult an infertility specialist online --> https://www.icliniq.com/ask-a-doctor-online/infertility-specialist


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