Blocked tube/IVF

[November1500]

Hi I was just wondering if someone could please give me some advice as I’m driving myself crazy. I have had a HSG test which showed left tube is blocked. The fertility consultant has put me on the IVF waiting list ( should start in a few months) he said that he doesn’t think we should have the tube investigated but I’ve read up so much online and I really think I should have a lap test done to see if there is any fluid stuck in there etc? That fluid can be harmful from what I’ve read and I don’t understand why they wouldn’t want to check for that first before starting IVF. I really want the best chances with IVF but I feel like I won’t be going into it 100% positive knowing that things could be looked at?

I completely understand that feeling. You have two options, as I see it: trust the doctor who has done this probably hundreds, if not thousands of times, or go to someone else (possibly private).

Yeah I looked into private but it's to expensive. I just don't understand if there is a possibility of there being fluid why they wouldn't want to check it first before going through IVF.
Just wondering if anyone else has had blocked tubes and not had them looked at and just gone straight to IVF and had success

The point is that IVF bypasses the tubes so it really does not matter what's going on it there.

I had ivf for male reasons and had barely any tests - because it really doesn't matter what the tubes are doing - they remove the eggs form the ovaries and put straight in the womb. Tubes are irrelevant for ivf!

Good luck

Thank you for your reply.

It's the fluid that is in the blocked tube that's harmful and only a lap test can see if it's there

A HSG uses a liquid that shows up on x-rays to show whether your Fallopian tubes are patent. If like you say your left tube was blocked due to liquid this other liquid would have gone through. It is highly unlike your tube is blocked due to what you’re saying but because of something else such as scar tissue.

A lap and dye is a similar procedure but the gynaecologist looks with a camera rather than X-ray - it’s surgical.

Also have you been trying long? My right side is blocked and I have conceived 3 times naturally- some first time it took 2 years.

Hi. Yeah we've been trying for 3 years. What I wanted to know is should I have a lap done to try and flush tubes out and see if the tube has the harmful fluid in it that can harm pregnancy happening or not bother and go straight to IVF. I don't see how going straight to IVF without investigating the tubes first makes sense when I could possibly have this harmful fluid that would make IVF not Work

My understanding is that a hydrosalpinx can be seen by hsg. It too used the same dye to 'flush' through the tubes.

Ask the doctor about what can be seen on an hsg vs lap - but honestly unless you are willing to go private, trust your doctors. Have a conversation about your concerns and see what they say. They've seen it all before... Just choose to trust them. Or don't and go another direction.

If your tube was fully blocked the fluid shouldn't leak, if there is fluid they can see it during an ultrasound scan usually and it can sometimes be drained at egg collection if the consultant thinks it's needed.

Also having them flushed out usually means they reblock again and you could end up at risk of ectopic and end up with a leaking hydro rather than a closed one, I would leave it alone if they are confident it's a full blockage

I had a right hydrosalapinx diagnosed after a HSG and further looked at with a lap, my IVF consultant was very clear that she wanted this tube removing before starting IVF as she described the fluid contained within as being a bit like stagnant water dripping into the uterus and some research shows that this doesn't provide the best environment for an embryo to implant. I had the tube removed figuring I wasn't getting pregnant with it might as well try without and I still didn't get pregnant but consultant happy to then commence IVF and I'm now 7 weeks after our first round.

Yeah I see what your all saying about trust the doctor. I think I'll ask to speak to him again about my concerns. I was under the impression that you can only see that harmful fluid if you have a lap done only.
He said to me if IVF fails then they can investigate the tubes but Surley it would be standard to investigate beforehand. I've been driving Myself crazy and gone from feeling excited and positive to feeling so negitive and unsure

Congratulations on your pregnancy. So was hat fluid seen from your HSG or the lap?

If I'm honest I can't really remember I had the HSG done which showed one tube didn't do what it was meant to I then had a lap and dye where they had a bit more of a poke around and it was after that they decided the tube would be best coming out so the lap was probably the decider I think. I think my first consultant wanted to explore every avenue before she ref me for IVF as on paper there is no reason why me and DH shouldn't be able to concieve but it just didn't happen naturally for us.

Yeah see this is why I'm sure anyone with a blocked tube should have a lap and dye done to check before they go for IVF. I really am so confused and feeling not feeling great about it all

Unfortunately, laps are far less frequently given... there are risks with any surgery so they don't bandy them about.

Are there indications you actually have a hydrosalpinx or just a blocked tube. Again discuss this with your doctor.

Honestly, the approach I have seen is try ivf - diagnosis of a problem could cost the nhs thousands and not solve the problem. I had a sum total of three blood tests and 4 ultrasounds, 6 months of clomid and straight to ivf. And yes, I did already ovulate and no they didn't look for or find a reason for our infertility. That approach may be incredibly frustrating (it was for me that they didn't give a shit why I couldn't get pregnant). But they will do what is medically necessary and that's about it.

Discuss hydrosalpinx with your doctor - there may be a very good reason why they think you don't have one and this are not willing to offer you a risky lap...

Hi. Thanks for your reply. Yeah my periods are like every 2-3 months and I don't ovulate on my own. I paid private to have the intial tests done then had 3 months worth of clomid, then had HSG then had a further 3 months of clomid whilst waiting for the HSG, which I ovulated on but never caught as my folicule was growing on the side that's blocked. I hope it's easy to get to speak to the consultant because otherwise I'm just going to drive myself mad. Was your HSG ok and how was IVF for you?

They didn't give me an hsg or hycosy or similar. They tested for chlamydia antibodies and I didn't have any so they said my tubes couldn't be blocked (???!). So that was a huge cause of frustration/ concern for me.

I'm currently 8 weeks from my first successful round. I am unbelievably grateful. I would give anything not to have had that added aggravation with the consultant. At the end of the day, I'm an educated layman and he is an expert. And that's probably the problem I had...

I'm glad it all worked out for you though. I've gone from feeling so excited to start IVF to feeling very nervous and negitive about it all because of my blocked tube. I hope I get to speak to consultant and get some answers to help me

And I hope that's all it takes for you to get the info you need and it makes you feel a bit better about things!!!!

Thank you will update you 🤞🏻

My understanding is that a hydrosalpinx would normally be visible via ultrasound and during an HSG, because the tube would be distorted in a recognisable way. There's a remote possibility that a blocked tube could be a very small hydrosalpinx not diagnosable via those means, but I imagine your doctor is balancing that against the risks of having a lap and on balance isn't seeing any benefit to the latter. I mean, talk to your doctor again if you're really concerned (or eat the cost and have it done privately) - but there are many, many ways in which IVF can go pear-shaped, and unfortunately you can't control or predict them all. Good luck!

I always get weird twinges down there aswell so that makes me think is there something else happening and is it fluid etc. I know what you mean though. I just wanted to see if anyone else had blocked tube and just gone straight to IVF

Hi November. My right tube is blocked (hydrosalpinx) and it was diagnosed via ultrasound (internal) and a further MRI scan. It’s pretty swollen (several CM 😳) so it wasn’t hard for them to locate. I am having my tube removed surgically next month. They gave me the option of having it ‘clipped’ to keep the fluid from escaping as it is toxic to embryos so couldn’t start IVF without it (undecided on that but that is another story!) however because I get pain and discomfort especially at certain times of the month I have opted to have it removed and they have agreed. I now can’t wait to get rid of the damn thing as aside from that all my tests have been ok.

Good luck - definitely worth a second option or asking for an MRI.

Hi. Aww no sorry to hear that. Hopefully you'll feel much better after the op. I had a 2nd opinion on everhthng with my private consultant and I haven't got fluid but have a cyst which they need to keep a eye on. Said if it gets bigger I'll need a lap to remove it so have to have a scan in 6 weeks

Hi @November1500 I had a HyCosy scan back in January from which they could see that both tubes were blocked. I was then told I needed a lap so they could see more closely what the problem was. Unfortunately due to NHS waiting lists I didn't have this until June, the 6 month wait was very frustrating!! They did the lap, saw that both tubes were blocked as both narrowed in the middle and said there was nothing they could do, was referred to ivf. And now our first appointment is next week. I feel like in a way that 6 month wait was a waste of time so if you can move straight to ivf it might be for the best?