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Mild to moderate blockage.

HSG Hydrosalphynx Tubal Issues Tubal Inflammation Medications vs. Surgery Salpingitis

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#1 Seem14

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Posted 22 September 2015 - 12:22 AM

Hello there, 

 

I am completely new to this forum and overall to this journey of infertility.  I literally just got out of our first consultation at the infertility clinic today as I was referred there by my gyne.   The whole experience was HORRIBLE.  We went to PCRM and met with Dr. Niamh Tallon (yes, I tried researching her before but couldn't find that many reviews until today on this forum which was a little too late for me). 

 

Overall, I would NOT recommend this doctor as she was cold and quick to brush off any hope that you might have. The whole time she basically just focused on getting rid of my tubes and go for IVF.  I had to ask her how bad my case was, and she hummed and hah and said well we won't know until we do a laparoscopy. Meanwhile, I had a quick glance of that report from my HSG U/S which said mild to mod blockage (I didn't see if it was bilat or uni).  I had to ask her again of my chances of getting pregnant, if say it was mild once the lap has been performed, and we can somehow salvage my tubes, and she said, no chances and that it's not going to be good and even if we repair it NOBODY can say it will stay open for HOWEVER long and that the real chance is if we just (best) remove my tubes or (second best) clip them.  My DH even ask what if the one tube is good and she said again, NO that if my one tube had been inflamed it's more likely that the other one is inflamed too, causing fluid build up as we;;, and that the likelyhood of an ectopic pregnancy is high that it could be life threatening and that our only chance is IVF. Don't get me wrong, I am not opposed to do IVF I am actually relieved that at least I have that option still open to us.  It's just the way she was during the consult, she was unsympathetic, didn't give us any hope whatsoever, and I felt like I didn't really understand where my situation lies as far as severity goes.  All we heard was NO, NO, NO to every possible (and positive) scenarios we had offered.  She basically made it sound like my tubes are damaged!!!! and I asked her about that. She just basically hammered it in our heads that my tubes are inflamed, inflamed, inflamed and have fluid in them and that's it - therefore remove them.  

 

My question is, IS THERE ANYONE HERE who treated that inflammation by using antibiotics first? My train of thought is that if it is inflamed then it's gotta be infected (and yes, we went for STD checks etc and she said nothing about those) and if it is then medications first? 

 

If that's not the case, anyone here had reparation of tubes, and how successful is that?  I'm just trying to think of other ways that can possibly avoid removal or clipping of my tubes, and save my tubes...... I just really am not understanding her way of treatment.  I understand the problem, but her approach seemed a little drastic for me and my hubby.  I almost felt like she was pushing us to go for IVF as opposed to trying to save my tubes for possible natural conception......

 

She did an ultrasound of my ovaries and found that my ovaries are slightly small in size for my age, but are otherwise healthy and that she found 5 eggs in one of them which she said is low in number for my age but are otherwise healthy too.  She said she saw my tubes but not super enlarged that she could totally see them.

 

Any type of advice or share your experience would be extremely helpful.  I did manage to book with my gyne in two days so I can also ask her and also get another referral to another infertility clinic.  I definitely do not want to see Dr. Tallon again.

 

Thank you so so much for reading and responding!  

 

Much love.

 

 

 



#2 CdnHockeyGal

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Posted 22 September 2015 - 07:36 AM

Hi Seem,

I know this isn't what you're hoping to hear but Dr Tallon provided you with extremely accurate medical advice. If your tubes have fluid build up, you have a hydrosalpinx in your tubes. It is close to impossible to conceive both naturally and with IVF without the removal of your tubes. The fluid build up spills toxic fluid back into the uterus and kills the embryos. Your chance of a successful pregnancy with your existing tubes that have hydros is less than 10%.

You'll need some bloodwork done to determine your FSH, AMH, LH & progesterone levels. That information, in conjunction with your age will give your RE and accurate assessment of your chances of success utilizing IVF. If your AMH is low (indicates the number of eggs in reserve in your ovaries) you will may be diagnosed with DOR, which is again, far most successful being treated with IVF.

Both of these diagnoses are emotionally devastating as it sinks in how hard things will be and that you will require medical intervention to help you succeed. Having both tubes removed for hydros & DOR...trust me....I get it. The good news is though that with proper care & intervention your odds of go up dramatically.

I'd encourage you to do your research, ask questions & be an active participant in care. While you may not have "clicked" with your RE - she has provided you with medically accurate.

Best of luck to you in hour journey!
It was long, awful & hard. We got very lucky and didn't run out of both emotional and financial resources. We saw some of the most beautiful of people in our lowest moments. Baby Girl arrived Apr 10/2018

#3 Watermelon

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Posted 22 September 2015 - 10:53 AM

Hockey girl is correct I'm afraid.

That said, if you feel that that information was delivered in an insensitive and unempathetic way by the doctor you saw, I would absolutely encourage you to interview other REs and find a clinic in which you are made to feel like a partner in your health. IVF and infertility are emotionally, physically and financially extremely straining. While I hate to say it, the journey is often full of difficult outcomes, results and realities. Those caring for you should be able to deliver and discuss such news in a way that does not leave you feeling even more raw.

Wishing you all the best
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Me -29 31- unexplained poor egg quality. I was told I had endometriomas.....but repeat ultrasounds at other clinics have said no sign of endometriomas. Maybe PCOS-like ovaries, but no PCOS - AMH, AFC are great. No one can explain why my eggs are so poor sad.png

DH 30 - severe teratospermia, count and motility are excellent.

May 2014 - 2.5mg femara - BFN (ovulated night before)

June 2014 - IUI with 5mg femara - BFN (ovulated night before)

August 2014 - IVF with ICSI - Antagonist protocol, 150Bravelle, 75 menopur, stimmed 8 days

- 19 follicles (all 15-22mm at trigger), 12 eggs retrieved, 7 mature,, 5 fertilized with ICSIsad.png

- only 7 mature eggs with an estrogen of 20000?! wtf?! Sigh...Freeze All

-only one BB Blast made it. Freeze "all" became "freeze one". All others arrested between day 3 and 4 sad.png

January 2015 - FET of lone embryo - c'mon little figher

- BFP!!! Beta 1 475 at 10dp5dt , Beta 2 - 1495 at 12dp5dt

Baby boy born Sept 28/15


#4 Seem14

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Posted 23 September 2015 - 12:00 AM

Hi CndHockeyGal and watermelon,

 

Thank you kindly for the replies.  I'm still struggling with my diagnosis and just trying to cope as time goes by.  As far as we know, it's just my tubes that are causing infertility. I have had all the battery of tests needed for my consult and the only thing now that I'm waiting for is that laparoscopy (I suppose to confirm how severe my case is, and most likely to remove as opposed to repair my tubes).  Dr. Tallon didn't not say a peep about those bloodtest, nothing about my hormones, anitgens etc (which were ordered) - so I'm guessing those are ok. She only discussed my HSG U/S result.  She did an U/S of my ovaries in her office and said they were fine and that I have eggs.  So I guess that's something good.  I don't really know what to think or expect at the moment, but I will be seeing my gyne tomorrow.  Thankfully, her secretary was able to squeeze me in, so I'll be asking her about those test results as I'm far more comfortable with her than the RE and ask for a new referral to a new RE..........

 

Hoping that tomorrow will feel better...... 

 

Thank you again.....



#5 Highest hopes

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Posted 23 September 2015 - 12:22 AM

Sorry to hear of your negative experience :(

I feel for you.  It's devastating news.

 

I agree with all the other advice given for the most part. Though a tube blockage isn't necessarily a hydrosalpinx (dilated/fluid-filled). Either way, a blocked tube is a problem and could become hydro and/or cause ectopic. It is possible for them to try and fix it with surgery, but a higher chance of success to move to IVF.

 

By the way, do you have any symptoms of endometriosis like painful periods, gastrointestinal issues, heavy or irregular periods?

Sometimes endometriosis can cause tube blockage.  If this could potentially be the case, you might want to have your surgery done by the BC Clinic that specializes in Pelvic Pain and Endometriosis. If they see any Endo during the lap, they would be able to properly remove it.

 

My experience was that I was found to have a hydrosalpinx and I was very upset, like you, though I was in my 40s so I already knew that my chances were slim, therefore not as devastating as being younger when one doesn't expect problems. Anyway like you I questioned all the advice and I even took out a huge textbook from the library called "The Fallopian Tube" on interlibrary loan, and that's where I read medical chapters about how they can fix the tubes. You would have to try to find a specialist willing to do that. And it's true that it may not work and in the end you might need another surgery to fix it or remove it later.  It really depends on your age and whether you have the time to explore that option, like many years to recover from surgery then try again another year let's say, then if it doesn't work then schedule another surgery and then remove your tube then if it's still not ok, etc. I'm very sorry to say, that 5 eggs isn't optimal so honestly I don't think you have that kind of time to spend. 5 eggs is still enough though, if you do pursue IVF.

 

For me I had hydrosalpinx in one tube only and like you I wondered if antibiotics would help but if they don't think it's an active infection then it won't help. Antibiotics doesn't treat inflammation, it treats bacterial infection. Anyway I had my one tube removed (which turned out to be from endometriosis) and the doc said exactly the same thing to me about the other tube is likely damaged so he recommended removing both. Like you I didn't want this and begged him to agree to check the other tube during surgery and if it looked ok, to remove it. So that's what we did and it looked normal so he left it. 6 months later I had a scan to prepare for embryo transfer and my remaining tube is now hydrosalpinx which is believed to be caused by adhesions that formed since my first surgery.  I am now about to have my second surgery to remove it, as I've read it can lower the chance of success by 50%  :(

 

I'm so sorry, just want to share any info I can.  But I agree that you need to find a RE that you feel is compassionate and that you connect with.

 

Best of luck sorting it out, I know it's rough, to say the least.


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#6 Seem14

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Posted 23 September 2015 - 01:45 AM

Highest Hopes,

 

Thank you so much for sharing your story with me.  It was a really hard day today at work, I couldn't help but have a bathroom-cry break while messaging my husband.  I just keep having outbursts just at the very thought of it. I know it sounds all very dramatic and I never thought I'd be the one to be acting like I have been, but just the thought of me being infertile is very crushing...... I know, I will do my very hardest to accept it and move on. I have to.  And I have to thank this forum for shedding me some kind of light that I very much lost yesterday.  I'm still not quite ready yet to share this news with our immediate family members.

 

My GP, Gyne and RE all asked me the same questions about pain during menstruation, sexual intercourse, back pain etc., any feeling of abnormalities surrounding my period.  They asked me if I have painful ovulation and if that my periods are regular, all that stuff, and to be honest I can't think of any pain of any sort, nothing.  My period always came at about 28-32 days.  And I can't even say anything that's notable, nothing.  So I don't know what it all means.

 

As far as the ovary u/s she did, to be honest, I don't really know how thoroughly she looked around. It was really painful when she did it, and I felt like it was more like "oh there it is good, and oh there's the other one, that one looks like it has 5 eggs in it" type of comment, as if they were more of an incidental finding as opposed to what she's really looking for. I don't know.  She seriously hardly explain anything to me or my hubby.  

 

So, I'm totally new to this and I have a lot of things to learn but what does 5 eggs mean?  Does it mean that's all I'm gonna have for the month? year? ever?  What's the normal healthy numbers of eggs anyway?  OH and I'm turning 33 years old next month.......

 

Always grateful......



#7 Highest hopes

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Posted 23 September 2015 - 02:15 AM

I understand how shocking this news can be and it will take time for you to process, so I think all your reactions are normal and crying is actually healthy to release your sadness.

Glad it doesn't sound like you have endometriosis symptoms.

At age 33 if I were you I might try to find someone to fix the tube with surgery, but again the low number of eggs is a concern. It really depends on the results of the tests that CndHockeyGal mentioned. If they're not great (and it sounds like they might not be based on your egg count) then you should probably follow that doctor's advice, by removing at least the problem tube. I would probably still leave the other if it's ok. In my case it didn't work out, but I'm not sure if that's the norm, as they think now that I'm very prone to adhesions which not everyone is.

If they found 5 follicles in total that means you could expect to get up to 5 eggs retrieved that cycle (probably less as not all follicles contain eggs, or mature eggs). Then only a portion will fertilize, and survive. So you might end up with 1 or 2 embryos to transfer that cycle for example which isn't ideal but all you need is one. The next cycle though, you might have more follicles. But the follicle count doesn't often increase dramatically :(

Good luck with your appt and stay strong. There are lots of success stories after having tubal issues :)
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#8 Seem14

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Posted 23 September 2015 - 03:00 AM

Highest Hopes,

 

Thank you so much again for your encouragement.  I will definitely ask my gyne tomorrow about my other test results and  that possibility of low egg count and everything.  I am a smoker which I know is pretty much  a crime now in my case, and the RE did mention that, that smoking is most likely affecting my count and to quit promptly, which I am now working on as well.  Hopefully, that will somewhat help my case once I fully quit.

 

Tomorrow, I am hopeful that I at least would have a better understanding of everything and hopefully my gyne could at least tell me of possibility of our success...... I'm trying so hard not to be scared, but I really am.... I worry beginning from the cost of treatment,  to everything else that could go wrong (I know that sounds really pessimistic and I'm trying not to be).... but yeah, I'm scared.....

 

I will update you and everyone else tomorrow.... Hopefully I get to read more stories tomorrow....Hopefully, I still have enough time, as I'd like to at least have to kids.... arrgghhh... so many things going through my head.  

 

I can't thank you enough for responding, at least I don't feel so alone....(besides my hubby who's been really incredible through it all, it's nice to hear from other women who are experiencing the same thing I am)....

 

Thank you..... smile.png



#9 Seem14

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Posted 23 September 2015 - 06:35 PM

Just a quick update.  

 

I saw my gyne today and she went over the results with me.  She was very thorough and now I have a better understanding and a bit of acceptance as to what is going on with my body and why I would need such treatment.  She went over my blood work and she said everything is good except for a slightly elevated FSH at 14.4, which explains the low egg.  She did however say that I did ovulate on my own that month which is good and that the fact that the RE found 5 eggs is still encouraging and that she is positive that they can do something to at least increase my egg production (something like that).  She is sending me for a repeat day 3 FSH - I asked if things stays the same and she did say that at every cycle your FSH level and number of eggs are different though it doesn't fluctuate as much...  For the AMH, she's going to leave that order to the new RE if he feels it's necessary etc coz she said most likely they will look at my ovaries again..... OHHH and another good news, my gyne did tell me that she can do the lap and tubal surgery herself if I want to, and I couldn't be any happier!!!!  At least I have someone I trust to do the lap and the surgery - so that's another plus.

 

She is sending me to another clinic which I am happy about and I was able to request the RE *fingers crossed he's as good as the reviewers said  him to be biggrin.png *

 

I will be going to Olive Fertility clinic to see Dr. Jason Hitkari.....any feedback about him would be super helpful!

 

I'm finally starting to feel lighter about my issue and accepting that IVF could very well be our only option......



#10 Highest hopes

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Posted 23 September 2015 - 07:11 PM

Glad things are looking up!
What did your Gyne think about potentially trying to fix your tube? Or did she agree with removing? And one or both?
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#11 Seem14

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Posted 23 September 2015 - 07:31 PM

Oh right that, basically she said it would be hard to fix the tube(s), and even if she could, the success of it being open is pretty low and she's not keen on keeping them if they are swollen.  She was very good and considerate about it.  She basically said what she would like to do for sure is go in with the scope and re-examine them and if she sees that my tubes are unhealthy then she will proceed to remove them instead and will only keep them if she thinks I have a chance. So 50/50 I suppose depending on what she sees.

 

I think right now, I'm trying to shift my thinking and look at the other positive things that I still do have (ie: some eggs, reg ovulation and what not)..............and that IVF is still an option for us....... 



#12 Notamie

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Posted 17 October 2015 - 10:21 PM

My left tube is blocked as well and fixing the issue is turning into a huge headache. I finally am going to try olive to see what they suggest. My consultation is in January. Feels so far away. Any reviews on Dr. Nakhuda? I won't be in for my first consult just over the phone so I'm a bit nervous!!

#13 Seem14

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Posted 18 October 2015 - 01:49 AM

Hi Notamie,

 

When I went to see my gynecologist and after she explained it to me, it's almost as if it's a lot better to just remove the tubes.  Again, I don't know what exactly my situation is right now coz I haven't booked my lap surgery just yet (I'm waiting to see my new RE and start from there).  But from the sounds of it, even if she tried to "fix" the blockage the risk of scarring and all that doesn't seem worth it to me.  But again, I don't know yet just how badly my tubes are blocked.  

 

And crazy enough, I finally got a call from Olive as well yesterday! I can't be any happier.  I've requested for Dr. Jason Hitkari just because of the reviews online.  I wanted him to be my main RE.  Check him out.  He's apparently the #2 most reviewed.  The #1 most reviewed, Dr. Peter McComb, I couldn't find. I'm thinking he's prob not practicing anymore.  But it doesn't matter I'm excited to see Dr. Hitkari based on his reviews, and after our horrible first RE visit/ experience.  I'm seeing him in December! I'll let you know how it goes!

 

Good luck to all of us! flow.gif


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#14 Seem14

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Posted 18 October 2015 - 01:57 AM

Oh yes, I forgot to mention, I went for my second Day 3 FSH requested by my gyne and it went from 14.4 to 11.1... she said ideal is at 10.  So I'm almost there.... these days, I just focus and relish on other good things.  Just not gonna let myself feel that way again! (ie: the day I found out about my tubes). icon_question.gif icon_wink.gif



#15 Notamie

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Posted 18 October 2015 - 09:46 PM

Nice I'm glad things are going well. I hope your appointment is good and let me know how it goes. I did want Dr Hitkari but my referral said any doctor at olive. I'm sure Nakhuda is good too I hope! Yeah so crazy about blocked tubes I don't want to lose them but if that's my only option for a pregnancy I'll do it. I also have some hydrosalpinx too so many they will suggest that. The count down is so far away. I think my fsh is 7.9 but I'm going to go for another set of day 3 blood work if I finally get to day 3. It's the cycle that never ends!!!!!

#16 Notamie

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Posted 27 October 2015 - 01:05 PM

Did messenger or private email disappear for everyone?

#17 Seem14

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Posted 19 January 2016 - 03:21 AM

Hi all,

 

Just a bit of an update from when I posted in September.  I had my amh done about a month ago and finally got my phone consult today and basically he told me that everything is normal that my eggs are in good shape.  

 

Now the next step is deciding whether or not we should try to fix the tip of the tubes (fimbria) or just go straight to clipping my tubes.  I do have a fair understanding of the pros and cons of each procedures and I guess I'm just (a glimmer of hope I know, probably more like a wishful thinking) wondering if there's anyone here have much success with having natural conception by opening their tubes.

 

To be honest, my husband and I are leaning more toward clipping both of my tubes entirely as we think that our chances of getting pregnant is more likely.  But I think a part of me is just afraid of having to go through IVF and all that process that comes with it and think that somehow opening my tubes are just the simplest solution.  

 

Anyway, any feedback would be much appreciated.  (Oh and my husband also had been tested and passed with flying colors.  It's really just my tubes that are the issue.  Uterus has no issues as well.)

 

Many thanks in advance!  flow.gif







Also tagged with one or more of these keywords: HSG, Hydrosalphynx, Tubal Issues, Tubal Inflammation, Medications vs. Surgery, Salpingitis