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  1. Suyi
  2. Infertility Discussion
  3. Wednesday, 02 October 2013
  4.  Subscribe via email
Dear Doctor,

I'm suffering from second fertility with no problem conceiving my first child. My insurance covers diagnostic labs but not treatments, and I'm about to look for outside treatment options.


Me: early 30s, day 3 FSH 7.3, estradiol level 30, AMH 1.9. HSG showed one sided blockage / possible hydrosalpinx (no hx of infection that I know of)

Husband: semen volume 1mL, semen WBC >1, sperm count/mobility/morphology all normal


1) Is my AMH level a possible cause of my infertility?
2) Is laparoscopy recommended to confirm HSG finding?
3) Is it possible to REPAIR a blocked tube or hydrosalpinx (without clipping/removing the tube)? Or, is clipping/removing the tube the only way and is necessary prior to proceeding with IUI/IVF?
4) Is IUI or IVF recommended in my case with one blocked tube?
5) Is semen WBC > 1 a concern of possible infection? And is semen volume of 1L a concern?


Thanks so much for all your help!!!

Suyi
Accepted Answer
Suyi Accepted Answer Pending Moderation
Dear Dr. Tourgeman,

Thanks so much for your response. I just found out from HSG that both tubes were filled with dye. However, there was only very slight spillage on one tube and no spillage on another (no dilation/hydrosalpinx were noted).

1) If no hydrosapinx were seen, does it still require clipping/removal of the tubes (to prevent fluid drainage to uterus) prior to proceeding treatments like IVF?
2) Would going straight to IVF be a good option in my case, or further testing of the tubes is still preferred prior to receiving any treatments?
3) Would laporoscopy possibly damage the tubes?

Thanks so much again!

Suyi
Responses (2)
DrTourgeman Accepted Answer Pending Moderation
Hi Suyi-In general, if you have a hydrosalpinx it should be removed via laparoscopy. The reason is that the fluid inside the damaged fallopian tube is embryotoxic and can diminish your likelihood of conception even with IVF. Repair is usually not successful, and it may re-scar so that you will need to do surgery again.
At the time of laparoscopy your doctor can determine if IUI is a viable option, or if you will need IVF. All the other factors are not likely contributors here.
Best of luck,

David Tourgeman, MD

Edited by DrTourgeman - 03.10.2013 17:18
  1. more than a month ago
  2. Infertility Discussion
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