Low Basal Body Temperature and Tubal Obstruction in Infertility - Obstetrics and Gynecology

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Your situation is quite complex, and I appreciate your detailed description. Let's break down your concerns regarding low basal body temperature, tubal obstruction, and infertility treatment.

1. Low Basal Body Temperature and Ovulation:
Your basal body temperature (BBT) readings of 36.00 to 36.16 degrees Celsius, with some days dropping to 35.8 degrees, are indeed on the lower side. Typically, a woman's BBT rises after ovulation due to increased progesterone levels from the corpus luteum. If your temperatures remain low throughout the follicular phase (the first half of your cycle), it may indicate that ovulation is not occurring effectively. This could be due to several factors, including hormonal imbalances, particularly low progesterone levels.
The use of ovulation medications and estrogen can influence your BBT. If you took medications to delay your period, they might have an impact on your hormonal levels and, consequently, your BBT. It's essential to monitor your cycle closely and discuss these fluctuations with your healthcare provider. If you suspect low progesterone, your doctor may recommend progesterone supplementation, which could help stabilize your BBT during the luteal phase.

2. Tubal Obstruction:
Regarding your left fallopian tube being completely blocked and the right being open, it is possible for the previously patent tube to become obstructed over time due to various factors, including inflammation or scarring. If you are experiencing post-coital vaginal inflammation, it could indicate an underlying issue that needs to be addressed.
Since it has been over six months since your last hysterosalpingogram (HSG), and you have not achieved pregnancy, it may be prudent to consider a repeat HSG or a laparoscopy. A laparoscopy can provide a more comprehensive view of your reproductive organs and allow for potential treatment of any identified issues, such as adhesions or endometriosis.

3. Use of Ovulation Induction Medications:
If you have been on ovulation medications for over six months without success, it may be time to reassess your treatment plan. Your doctor’s suggestion to take a break or switch to injectable ovulation induction medications (like gonadotropins) could be beneficial. These medications can sometimes provide a more robust response in terms of follicle development compared to oral medications, especially in cases of polycystic ovary syndrome (PCOS).

Even if you are not pursuing in vitro fertilization (IVF) or artificial insemination, injectable medications can still be appropriate for stimulating ovulation. However, this should be done under close supervision by your healthcare provider to monitor your response and adjust dosages as necessary.

In summary, your low BBT may indicate issues with ovulation, potentially linked to hormonal imbalances. The status of your fallopian tubes should be evaluated further, especially given your history of blockage and inflammation. Lastly, consider discussing the possibility of switching to injectable ovulation medications with your doctor, as they may offer a better chance of stimulating ovulation effectively.
It's crucial to maintain open communication with your healthcare provider, who can guide you through these challenges and help tailor a treatment plan that suits your specific needs. Wishing you the best on your journey to conception!