GUIDE HOW HYSTERO SALPINIGO GRAPHY (H.S.G) COULD BE TREATED

If one tube is blocked also the prospective mother can conceive easily if one ovary or tube removal for some reason surgically also she can conceive easily. HSG is done on 5^th to 9^th day of periods after stopping of bleeding. It  shows uterus if any guidance of anomalies of uni / bicornuate /septate / fibroid pressing the endometrial cavity. 

Fig 1.1 HSG 

Tubal outline is seen and free peritoneal spill is indicates the patency of tubes. There can be corneal / fimbrial block. Corneal block can be cleared by canulation by fluoroscopy / Hysteroscopy fimbrial block can we tackled in some cases by fimbrioplasty or salpingolysis by laproscopy.

If tube is dilated and filled with fluid is called hydrosalpinx it is due to late effect of infection. In case of hydrosalpinx it prevents conception and chances of tubal pregnancy is more.

If both tubes are damaged the choice is to go for IVF (Test tube baby). Tubercular tubal disease (Hydrosalpinx / tubo ovarian mass / ascities) also some times seen. Here I am presenting some of my patients stories.

Fig 1.2 Doctors Treatments HSG

TUBAL PREGNANCY

           

Haritha had ovulatory dysfunction. Her follicle development was slow. So we gave her FSH injection along with clome. Her follicles developed, the next month she came with conception. 

When we sent for  scan around the 7week,  The snologist diagnose combined pregnancy  (Heterotropic pregnancy) ie., one inside the uterus and other  in the tube. We suggested surgery for the tubal pregnancy and expressed our doubts about the continuation of the normal pregnancy because it was a life threatening situation. They accepted for surgery.

Just before one day of surgery she developed severe  diarrhoea. We treated and went ahead with surgery. Post operatively she developed severe wheezing problem. We almost gave up hopes on continuation of the normal pregnancy because of this complication. She was discharged, after 10 day when we did the scan the fetus was viable. We were extremely happy she went on to deliver a boy baby. Later she had one more boy baby.

                 Fig 1.3 Tubal pregnancy and Treatments 

Ajanta was married for 7 years. She had surgery twice done for endometriotic  cyst. She had ovulated well the other side but she was not conceiving. We suggested for the surgery she was hesitant so Suddenly her close relative passed away and they were diverted to that incident and stopped treatment for 6 months. She conceived in that mean time.

Another lady came around 31 years and married for 8 years. One side ovary already removed the other side also surgery was done it was recurred the operator told that the tube was not healthy. So she was suggested IVF because she has to save money for IVF she postpone it for 1 year, she conceived in the mean time.

Fig 1.4 Treatments and equipemnts used for HSG

Sharmila came with recurrent endometriotic cyst ON both sides. She was following natural diet and exercises and positive thinking. The cysts disappeared and conceived naturally and delivered a girl baby.

Video1.1 Journey of Natural  Conception 

Jayanthi was married for 7 years and came for suggestion of treatment of Anemia. I suggested for correction of anemia and adenomyomectomy as she was not having a child. She was very happy because somebody has suggested her hysterectomy and I wrote iron tables and suggested diet and she went away. 

This happed in January. She came prepared for surgery in April. When we checked her hemoglobin percent it was 70%. I asked her to go for scan in case if there is increase in adenomyosis in the mean time. She came back with the report of 7 weeks pregnancy. She delivered a girl baby.