What is on the differential for *proximal* tubal occlusion on HSG?
It may represent an artifact from tubal spasm.
Does HSG lead to slightly decreased fertility in the future?
Actually, the evidence seems to suggest that the "tubal flushing" that occurs with an HSG actually may increase fertility (reference 1).
There is a filling defect low in the uterine cavity, extending toward the cervix, compatible with an intrauterine adhesion.
The fallopian tubes fill and spill normally, with normal dispersion of contrast in the abdominal cavity.