Both Tubes Look Blocked Near the Womb on HSG: What Needs Confirming?

A report saying both fallopian tubes appear blocked near the womb can make a fertility appointment difficult to absorb. Ask the clinician to explain the precise finding before you turn it into a conclusion about your future.

Myth: that finding always proves a permanent blockage

ASRM’s 2021 fertility-evaluation opinion says findings suggesting bilateral proximal obstruction need further evaluation. Temporary contractions of the tubes or uterine muscle, or the catheter’s position, can create an artifact affecting the result.¹

That does not establish that your tubes are open. It means the specialist needs to interpret what the examination showed and decide how to clarify it.

Ask: “Do you consider this a confirmed blockage or a finding that needs checking? What on the images supports that interpretation?” Request an explanation you can take away with the report.

Myth: every further check must be an operation

ASRM does not recommend laparoscopy as a routine test of tubal patency. It describes selective tubal cannulation as a method that can confirm or exclude a suggested proximal blockage and may also allow recanalization.¹

Ask which assessment your team recommends and what question it will answer. The fact that an option exists does not make it the right next step for every patient. If another procedure is already planned, ask how the investigations fit together.

You can ask about the decision without arriving with a procedure chosen.

Myth: opening a tube settles the whole fertility plan

Rotherham describes recanalisation as trying to clear a blockage with a catheter and guidewire under X-ray guidance. Its patient leaflet says the radiologist discusses benefits, risks and alternatives before consent; it also acknowledges that opening one or both tubes may not be possible.²

Ask the specialist to distinguish the result of an attempted tube procedure from the wider discussion about becoming pregnant. Request advice based on your full assessment, rather than another person’s procedure outcome.

If recanalisation is proposed, ask for your own preparation, comfort and aftercare instructions. Do not borrow medication instructions or a timetable for trying to conceive from someone else’s leaflet.

Keep the next decision specific

Before leaving, write down what is established, what remains uncertain and who will explain the next result. Ask what happens if further assessment confirms a blockage, and what happens if it does not. Bring your partner or another support person into that discussion if you want to.

Period, Handled includes a Flag It list and visit script. Use them to organize the questions you want answered about the report and proposed next step. Explore the periods playbook.