HSG Result

[Choice4]

Dear Dr
This is my HSG report of 15th Dec 08

"The uterine cavity is slightly elongated and there is some irregularity along the fundal margin and right uterine wall consistent with the histry of fibriod disease. There is slightly more discrete irregularity and underfilling in the left cornual region, which may represent a post op apperance or a small area of filmy Adhesions cannot be excluded.
There are no other discrete intra-uterine filling defects detected. The right fallopian tube fills throughout its lenght with spill demonstrated. There is only faint filling of the left fallopian tube detected despite using patient position to aid spill".

I have a previous history of mymectomy march '08, 1st ivf Bfn, 2nd ivf thin lining and fluid in the cavity. I am 40yrs old

My Questions are
a. Do I have Asherman's synd. an RE says I do?
b. Is my left tube blocked?, do i need to remove it or unblock or cathertierise it. Do i have hydrosalpinx?
c. I plan to have hysteroscopy soon, for lysis of adhesions.
would this stop the fluid in the cavity and allow the lining to respond to drugs.
d.Ultrasound shows, 4intramural fibriods, endometrial cavity distorted and contains some fluids.
e.My last period was on 10th Nov, I have not had any period since then, I have had Im progesterone

[Scott Roseff MD]

Hi,

It's impossible and illegal for me to diagnose your condition from afar, especially since you're not under my care. Therefore, I'm doing the best I can do to answer your questions, below; If you want specific responses, you'll need to schedule a second opinion consultation here in South Florida:

a. Can't say (sorry).
b. The dye didn't go into the left tube on the HSG you described. There are several reasons for dye not going into a tube on an HSG. These include, and aren't limited to, spasm of the smooth muscle of the tube, scar tissue in the uterus, scar tissue in the tube, insufficient pressure during the procedure, and preferential filling/spillage of the opposite tube. In my own patients, when I perform their HSG's and find the dye doesn't go into their tube, I often give them a medicine (called Glucagon) to relax a possible muscle spasm; I sometimes may selectively catheterize the tube to push dye directly into the tube at the time of the procedure as well.
c. There are many different reasons for a thin lining and fluid in the cavity. Some of those reasons may be diagnosed/treated at the time of hysteroscopy.
d. Some RE's suggest removing intramural fibroids IF they distort the uterine cavity.
e. Progesterone can potentially prevent a menstrual period, depending on how long ago it was given. Again, it's not possible to say if that's why you haven't menstruated without having more information about your history.

I know the above is limited, but I truly hope it's of some help to you.
All my best! Dr. Roseff

[Choice4]

Thank you Dr Roseff for you quick reply