Pelvic Adhesions
10 Replies
WI102 - August 21

Dr. Jacobs,

First, thank you in advance for taking the time to answer my question. I was told that pelvic adhesions from a previous appendectomy may have caused a hydrosalpinx in my right tube. What are the chances that my other tube may also be affected by these adhesions although the HSG showed that it was open? Can pelvic adhesions be one-sided?

Thank you again for your advice.

 

B. Jacobs, M. D. - August 21

If your problem was caused by appendicitis, your left tube may be OK. If you have a hydrosalpinx on the right, that could causew a problem. In circumstances that a hydrosalpinx is caused by tubal infection, embryo implantation rates are very poor, unless you remove the hydrosalpinx.
Good luck.

 

WI102 - August 21

Dr Jacobs,

Thank you very much. Does that mean that if my hydrosalpinx was not caused by an infection it may not have to be removed?

Thanks again.

 

B. Jacobs, M. D. - August 22

I'm sorry, but I have no data to answer your question. My inclination would be to remove it.
Good luck.

 

WI102 - August 23

Thank you again for all your help. One last question....I realize this may be difficult to answer, but what do you think my chances are to conceive naturally with this condition (assuming my left tube is normal)? Does the size of the hydrosalpinx affect my chances (i.e. smaller hydro correlates to better chance of conceiving?). I apologize of these questions are somewhat naive.

Again, thank you.

 

B. Jacobs, M. D. - August 24

Since I have not evaluated your pelvis, I cannot have a valid opinion about your chances of haveing a successful pregnancy, without medical intervention. From you description, your best opportunity may be IVF. If your left tube and ovary are normal, you do have a chance, but your odds are less, compared to having 2 normal tubes and ovaries. In all our discussion, we have not addressed ovarian function or male factor issues. About 40% to 45 % of infertile couples have a male factor as part of the problem list.
Good luck.

 

WI102 - August 24

Dr. Jacobs,

Thank you, thats kind of what I figured. I don't have any ovulation or hormonal problems, and my husbands SA was well within the normal range. The hydrosalpinx is the only problem that has been identified. Thank you for all your help, I certainly appreciate your honesty.

 

WI102 - September 2

Dr. Jacobs,

I hate to bother you again, but I recently saw an RE and have another question. She told me that since only 30% of my right tube was moderately dilated (left one looked normal on HSG) the fluid may not cause a problem for embyro implantation. So she agreed with my Ob/Gyn that since we have only been trying for about 8 months, are relatively young (30) and have no other problems, we should continue trying naturally. Do you think this is reasonable or should I find another RE?

Thank you!

 

B. Jacobs, M. D. - September 2

Unfortunately, I cannot provide a valid opinion without evaluating you.
Good luck

 

WI102 - September 25

Dr. Jacobs,

My doctor wants me to try Clomid for 3 cycles. I don't have any known hormonal problems, and my cycles are very regular. Is it still safe to be on Clomid if there are no known ovulation problems? Will it affect the size of my hydrosalpinx? I assume she wants to be sure that I am ovulating on my "good" side for 3 months in a row before doing any invasive procedures.

Thanks again.

 

B. Jacobs, M. D. - September 26

Clomid does not assure ovulation. Clomid can impair fertility in women who are already ovulating. If you have damaged tubes, the safest way to try to achieve pregnancy, and possibly your only real chance for pregnancy is IVF. I do not prescribe Clomid, and have not done so in almost 15 years.
Good luck.

 

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