QuestionHi,
Today i got the Ultrasonography of the lower abdomen and below were the conclusions from the report
1. Sonographic findings are suggestive of a small right simple hydrosalpinx.
2. The left ovarian cyst most likely represents an unruptured follicle.
3. Pelvic adhesions are suspected
My cycle period is of 30 days and during the test i was on 20th day. My menstrual cycle period of 30 days is very consistent and i dont experience any pain during menstrual cycle. My husband's sperm count is also normal.
With above problems what are the chances of conceiving. Will there any issues and what steps or treatment is recommended.
Thanks in advance for your support.
Sumitha.
AnswerHello Sumitha from India,
The ovarian cyst is called a corpus luteum cyst and probably resulted from ovulation based on the timing of your ultrasound. It is not a significant finding.
However, there are two significant findings that can influence your pregnancy chances. One is the hydrosalpinx. I don't know why your radiology clinic characterized it as a "simple hydrosalpinx", because this is not a standard description. You either have a hydrosalpinx or not. A hydrosalpinx is a tube that is dilated with fluid because it is blocked and the fluid cannot escape. This is significant because it confirms tubal blockage, which leads to the conclusion that there was an infection or inflammation that lead to tubal scar tissue formation and blockage. If you have a tubal event in one tube, it is highly likely that it also occurred in the opposite tubal even if the other tube was not severe enough to be blocked off. That tube may still not function. If you don't have normal tubal patency and function, you cannot achieve pregnancy by natural means. The only option would be IVF. With this technique the tubes are bypassed. In addition, the presence of a hydrosalpinx reduces IVF pregnancy rates by almost 50%, therefore, the hydrosalpinx needs to be removed or clipped prior to doing an IVF cycle. This is done by a surgery called laparoscopy. In order to verify that a hydrosalpinx is present, a hysterosalpingogram needs to be done. This is an X-ray procedure that is done whereby a dye is injected into the tube to verify if the tubes are open or not. The ultrasound is not the best method for making this diagnosis.
The second issue is the possibility of pelvic adhesions. Again, this indicates that there was some type of pelvic infection that occurred in the past. As a result there was inflammation in the pelvis and scar tissue was formed. Pelvic scar tissue is like spider webs. It will inhibit the egg from going from the ovary to the tube, and therefore, natural fertility will be impaired. In order to verify that pelvic adhesions are present, a laparoscopy would need to be done to look inside at the pelvis. Again, if this is the case, IVF is the treatment of choice.
If you were my patient and these findings were confirmed, I would recommend that you proceed directly to IVF. IVF would give you a very high chance of pregnancy (up to 73% per treatment cycle), depending on your age.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
