Orris
attachment
attachment

What is abnormal in this explains

analyse_media
Reading File
Searching the Web

ASRM fertility evaluation HSG hydrosalpinx tubal occlusion guideline

Searching PubMed

hysterosalpingography tubal infertility

Finding Sources
Finding Sources
This appears to be a hysterosalpingogram (HSG), an X-ray where dye outlines the uterus and fallopian tubes.
Likely abnormality: both fallopian tubes look dilated, tortuous, and blocked at their outer (distal) ends, with little or no normal free spill of dye into the pelvis. This pattern is most consistent with bilateral hydrosalpinx - fluid-filled fallopian tubes due to distal tubal blockage.
What it can mean:
  • It may impair natural fertility because the egg and sperm cannot meet normally.
  • Common causes include prior pelvic infection/PID, endometriosis, past pelvic surgery, or sometimes genital tuberculosis, depending on clinical setting.
  • HSG alone cannot confirm the cause, and sometimes tube spasm can mimic obstruction. A gynecologist/fertility specialist should review the original images and written report, often alongside ultrasound and clinical history.
A hydrosalpinx is defined as a distally blocked, dilated, fluid-filled fallopian tube by the ASRM glossary. The pictured appearance is similar to the textbook HSG description of bilateral hydrosalpinges: distended distal tubes with absent peritoneal contrast spill.
If there is pelvic pain, fever, foul vaginal discharge, or possible pregnancy, seek urgent in-person care.

What tests confirm bilateral hydrosalpinx?

Reading File
Searching the Web

ASRM committee opinion fertility evaluation hydrosalpinx hysterosalpingography laparoscopy tubal patency

Searching PubMed

hydrosalpinx diagnosis laparoscopy hysterosalpingography

Finding Sources
Finding Sources
Reading Web Page

https://www.asrm.org/practice-guidance/practice-committee-do…

Tests used to confirm or clarify bilateral hydrosalpinx are:
  1. Transvaginal pelvic ultrasound
    • Often the first follow-up test.
    • Can show elongated, fluid-filled, folded/tubular structures next to both ovaries.
    • A normal ultrasound does not fully rule out a mild hydrosalpinx.
  2. Hysterosalpingography (HSG)
    • This is the dye X-ray shown in your image.
    • Findings suggesting bilateral hydrosalpinx are: dilated tubes, contrast dye trapped in the tubes, and no free spill of dye into the abdomen.
    • It is the main non-surgical test for tubal blockage, but it can occasionally be misleading due to tubal spasm or technical factors. Berek & Novak's Gynecology reports HSG sensitivity and specificity for tubal patency of about 65% and 83%, respectively.
  3. Diagnostic laparoscopy with chromopertubation
    • This is the best confirmatory test when the diagnosis will affect treatment.
    • Under anesthesia, a small camera is placed through the abdomen and colored dye is passed through the cervix. The surgeon can directly see both tubes, whether they are swollen/blocked, any dye spill, adhesions, endometriosis, or evidence of prior infection.
    • It can confirm or dispute an abnormal HSG and allows the doctor to evaluate the tube surface and fimbriae directly. Berek & Novak's Gynecology describes this as validation of abnormal HSG findings by direct visualization.
  4. HyCoSy or HyFoSy
    • Ultrasound-based contrast tests that assess whether each tube is open.
    • They avoid X-ray radiation and may be used as an alternative to HSG, though laparoscopy is still preferred when the result is uncertain or surgery is being considered.
  5. MRI pelvis
    • Usually not needed just to diagnose hydrosalpinx.
    • It may help if ultrasound is unclear or doctors need to distinguish hydrosalpinx from an ovarian cyst, pyosalpinx, or another pelvic mass.
Practical next step: take the official HSG report and images to a gynecologist or reproductive-medicine specialist. If the report already states bilateral hydrosalpinx with no dye spill, they may confirm it with ultrasound and decide whether laparoscopy is necessary based on fertility plans, symptoms, and likely treatment.
Recent evidence also supports comparing HSG with other visual tubal-patency tests rather than treating any single test as perfect: 2026 Cochrane review.
attachment
attachment

What is abnormal?

analyse_media
Reading File
Finding Sources
Searching PubMed

hysterosalpingography proximal tubal obstruction

Searching the Web

HSG bilateral proximal tubal obstruction spasm ASRM

This HSG image shows contrast filling the uterine cavity, but I do not see contrast entering either fallopian tube or spilling freely into the pelvis.
Most likely finding:
  • Bilateral proximal tubal obstruction, meaning apparent blockage of both tubes near where they join the uterus (cornual/uterotubal junction level).
This image does not show the enlarged, dye-filled tubes typical of hydrosalpinx. It looks different from the prior image, where the tubes appeared dilated.
Important limitation: this may be an early image or apparent blockage due to transient tubal spasm, mucus/debris, or technique. The official HSG report and later delayed films are needed before calling it definite bilateral blockage. Confirmation can be done with repeat HSG/HyCoSy or laparoscopy with dye test, if clinically needed.
Recent reviews confirm that no tubal-patency test is perfect and equivocal HSG findings may need confirmation (PMID 42081299, PMID 40981166).
This is a shared conversation. Sign in to Orris to start your own chat.