A 30-year-old woman presents with a 3-year history of secondary infertility. Hysterosalpingography shows bilateral tubal occlusion at the cornual end. Semen analysis of her partner is normal. The MOST likely cause of this finding is:

• A Endometriosis
• B Congenital uterine anomaly
• C Asherman's syndrome
• D Previous pelvic inflammatory disease (Chlamydia) ✓

Explanation

Bilateral cornual (proximal) tubal occlusion on HSG is most commonly caused by previous pelvic inflammatory disease, particularly Chlamydia trachomatis infection, which causes peritubal adhesions and obliterative fibrosis at the isthmic-cornual junction. Endometriosis more commonly causes periadnexal adhesions and distal (fimbrial) occlusion. Asherman's syndrome affects the uterine cavity (intrauterine adhesions), not the tubes.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.