By AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE For The American Fertility Society
What is a Hydrosalpinx?
A hydrosalpinx is a blocked, dilated, fluid-filled fallopian tube usually caused by a previous tubal infection. The pelvic infections that lead to hydrosalpinx formation are usually caused by sexually transmitted diseases.
Diagnosis of hydrosalpinx is usually made by a hysterosalpingogram (HSG), an x-ray procedure in which a special liquid is injected through the cervix into the uterine cavity to illustrate the inner shape of the uterus and degree of openness of the fallopian tubes. If the tubes are open, the liquid will spill out the ends of the tubes. If the tubes are blocked, the liquid is trapped. Hydrosalpinx may also be diagnosed by laparoscopy, which is the insertion of a thin, telescope-like instrument called a laparoscope into the abdomen through an incision to visually inspect the tubes. They may also be visualized by ultra-sound.
Does a Hydrosalpinx Cause Symptoms?
Many patients with a hydrosalpinx suffer from chronic or recurrent pelvic pain, while others have no symptoms. Patients with a hydrosalpinx are more susceptible to repeated acute tubal infections, which cause fever and pain.
What Effect Does a Hydrosalpinx Have on Fertility?
If the fallopian tubes are completely blocked, conception will not occur without medical intervention. In milder cases, fertility may be restored by opening the tubes surgically. However, if the lining of the tubes is badly damaged, in vitro fertilization (IVF), which bypasses the tubes, is the treatment of choice. IVF is a method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg fertilizes and begins cell division, the resulting embryo is transferred into the woman’s uterus where it can implant in the uterine lining and further develop.
Although IVF is considered to be the best fertility treatment for hydrosalpinx, the presence of a hydrosalpinx appears to reduce the success rates of IVF. Fluid within the hydrosalpinx seems to reduce the embryo implantation rates and increase the risk of miscarriage. For these reasons, some physicians may advise removing the tube or separating it from the uterus prior to undergoing IVF.