Suggest treatment for infertility due to tubal blockage
Patient: Hi There! I am 30 yrs old, married for last 2.4 yrs, trying to conceive since two yrs by now, but not able to do so. Yesterday I went for a HSG test and the report says that there is irrgularity and beading , more marked distally near fimbrial end, suggestive of bilateral tubal block.All my previous reports are quite normal. Like my uterus is normal, ovaries are normal, cervical canal is normal, hormone levels are normal but still infertile. Please suggest. Doctor: Hallow Dear,Unless the tubes are patent, there is no chance of natural conception. However, your tubes are not just blocked, there is irregularity and beading in the tubes noted in Hysterosalpingography. This finding is highly suggestive of genital tuberculosis wherein the tubes are affected. Please get yourself investigated from a Gynaecologist for genital tuberculosis. Also look for presence of tuberculosis elsewhere in the body, particularly the lungs, by X-ray. Hysteroscopy will help to have a look at the endometrium for similar lesions. Laparoscopy will throw more light on complete pelvic health. If tuberculosis is confirmed, you will have to undergo antitubercular line of treatment. Tuberculosis can definitely be treated completely by treatment under observation; however treatment of tuberculosis is a prolonged treatment and for genital tuberculosis, you may have to take the medicines for at least 9 months. Along with the treatment, healthy high protein and high calcium diet with adequate Vitamins is necessary. Fresh fruits, fresh green leafy vegetables and fresh air to breath help speedy recovery. If tubes are affected by tuberculosis, the chances of natural conception are rather poor since though by surgery the tubal patency is regained, the tubal function is damaged. So after completion of the antitubercular treatment, you may consider Artificial Reproductory Technique for conception and pregnancy. One more suggestion, as per the WHO suggestions and our experience, every case of tuberculosis should be tested for HIV since tuberculosis increases the possibility of HIV infection six fold; so also HIV increases the possibility of tuberculosis six times. I feel you should concentrate first and more on getting healthy. Then later, attempts for pregnancy may be considered. Dr. Nishikant Shrotri