HSG or pelvic MRI?

[JourneyToParenthood]

Hi,

I had an ectopic pregnancy in January resulting in right tube removal via laparoscopy. During the pregnancy ultrasounds, fluid was noted in the left hand side of my abdomen/tube. However, after the surgery, the surgeon noted my left tube looked healthy.

We have been TTC since with no luck.

I went privately to a fertility consultant who did an ultrasound and, again, noted ‘tubal’ shaped fluid in my left side. He wasn’t sure if it was related to my cycle, so asked to see me 7 weeks later at a different point in my cycle. A second ultrasound showed the fluid again.

He now wants me to have an MRI to give him more information as to whether or not this is a dilated fluid filled fallopian tube. If so, laparoscopy and removal of my left tube is recommended which would leave me infertile. I am praying that it’s just a cyst of some sort, I can’t believe it could be my tube.

We’ve just found out that our insurance won’t cover these investigations or surgery. The NHS wait list is supposedly stupidly long.

I’ve been doing some reading and it sounds like a HSG or HyCosY is gold standard for tubal assessment although very invasive (it can also potentially clear blockages). I know an MRI won’t show if the tube is blocked, only if it is dilated. I assume the reason he has requested an MRI is because he recognises there is something there from the ultrasounds and he wants to understand what the fluid filled area is (which a HSG won’t show?).

Because I now need to self fund, I really need the most affordable option that’s going to be most effective in understanding the issue. I can’t really afford all of the various options - MRI, HSG and/or laparoscopy. Then potentially IVF too 😓

Can anyone help me? Or recommend my next steps or personal experience?

Thank you for reading.

Hi @JourneyToParenthood apologies I don't have many answers but also have experience with a blocked tube and am going through ivf as a result (unlikely the only factor but otherwise unexplained infertility). Mines was diagnosed through HSG but they did not remove it. Unfortunately though I have since had a failed embryo transfer and am curious about whether it could be influencing the outcome. Although I'm not sure if mines is a hydrosalpinx (fluid filled), if it is then it can leak fluid into the uterus making it toxic and can reduce implantation by 50%. If ivf is a possibility for you then you have the chance to bypass your tubes altogether - although I would advise getting rid of your other tube to avoid it influencing any outcomes. Appreciate it's not emotionally as easy as that though. Sending all the love xx

So sorry for the failed embryo transfer, I am praying things work out for you. It’s extremely tough, take care of yourself.

Yes, my consultant recommended that hydrosalpinx are removed prior to IVF. In fact, it is often the first step in the IVF process - he apparently does a lot of salpingectomy to prepare patients for their IVF treatment. Can you review the findings from the HSG to see if it was hydrosalpinx or scarring etc?

For me, I am hoping it’s a misdiagnosis, and perhaps it is a cyst of some sort. Because the fluid was noted back in Jan and the surgeon saw my tube and said it was fine.

If it is hydrosalpinx I will get it removed. We will then try IVF. I think I have a very anxious few months ahead of me and I am really spiralling into a bad place.

@JourneyToParenthood thank you. Unfortunately just one of those things. But yes you're right, ultimately I need to find out what's blocking it. I'm inclined to think it's not a hydrosalpinx as they never suggested removing it but I want to be doubly sure.

You're absolutely right to be cautious and not to jump to conclusions. Apologies if I was coming across as being blaze, I just remember feeling like my blocked tube was the end of the road only to have had a really good round of ivf (albeit with lack of success on our first embryo) but we have 5 frosties in the freezer and I feel hopeful that we will get there.

Infertility is an awful experience but you will find strength to bear it. Just make sure you do the nice things you need to do too. I know it's all consuming but hopefully the pain is temporary xx