Hydrosalpinx

Hydrosalpinx is one of the most insidious causes of infertility, as it often does not cause obvious symptoms, yet it can significantly reduce the chances of conception. If you have been diagnosed with hydrosalpinx or suspect that it is affecting your fertility, it is critical to understand how this condition impacts reproductive function and what treatment options are available. At our specialized IVF clinic, we offer personalized solutions to treat hydrosalpinx and increase the chances of achieving pregnancy.

What is Hydrosalpinx?

Hydrosalpinx is a pathological condition of the fallopian tubes, directly linked to fertility issues. The term refers to the accumulation of fluid in one or both tubes, which blocks their normal function and negatively impacts the conception process. Hydrosalpinx often goes undiagnosed for a long time as it may present no symptoms, and in most cases, it is discovered during fertility investigation or through imaging tests.

Physiology of the Fallopian Tubes

The fallopian tubes are two thin ducts that extend from the uterus to the ovaries. Their primary role is to allow the movement of the egg from the ovary to the uterus and to serve as the site where fertilization occurs. The inner lining of the tubes is covered with microscopic projections (cilia) that facilitate the transport of the egg and sperm, while their muscular contractions further support this movement. The integrity and functionality of the fallopian tubes are crucial for natural conception.

How the fluid forms (hydro-)

Hydrosalpinx forms when the tube becomes blocked and traps a clear or yellowish fluid inside, usually due to inflammation or infection. The most common causes are pelvic inflammatory diseases (such as salpingitis), sexually transmitted infections, previous abdominal surgeries, or even endometriosis. The blockage prevents the fluid from draining normally, leading to accumulation and dilation of the tube, altering its structure and function. This fluid may also be toxic to embryos or interfere with their implantation in the uterus, even during IVF cycles.

Symptoms & Diagnosis

Hydrosalpinx is a condition that often progresses silently, without obvious signs, making it particularly difficult to identify early. However, there are signs that may indicate its presence and tests that allow for clear diagnosis.

Most Common Symptoms

In the majority of cases, hydrosalpinx is not accompanied by strong or specific symptoms. Many women discover it incidentally during infertility evaluation. However, when symptoms are present, they may include:

Mild or chronic pain in the pelvic or lower abdominal area

Feeling of heaviness or pressure in the pelvis

Unusual vaginal discharge

Repeated failed attempts to conceive

Increased risk of ectopic pregnancy (in rare cases)

Obesity and unhealthy dietary habits are aggravating factors that worsen PCOS
symptoms.

Diagnostic Methods

Timely and accurate diagnosis of hydrosalpinx is crucial for planning the appropriate treatment. The main methods include:

Transvaginal Ultrasound

Detects enlarged or deformed tubes containing fluid. It is usually the first imaging method used.

Hysterosalpingography (HSG)

A radiologic exam during which contrast fluid is injected into the uterus and its passage to the tubes is monitored. It reveals blockages and how fluid is distributed within the tubes.

Diagnostic Laparoscopy

The most accurate method for confirming hydrosalpinx, as it allows direct visualization of the tubes. It can also be combined with therapeutic intervention.

Each case is unique and requires a personalized approach by experienced medical personnel.

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Impact on Fertility

Hydrosalpinx is one of the most serious gynecological conditions affecting fertility, as it interferes with both the natural conception process and the success of assisted reproduction methods. Recognizing and properly treating it is essential for increasing the chances of pregnancy.

Chances of Natural Conception

The presence of hydrosalpinx significantly reduces the chance of natural conception. Blocked or deformed tubes prevent the proper transport of the egg and sperm, making fertilization very difficult or impossible. Additionally, the fluid accumulated in the tubes may be toxic to the egg or embryo, creating a hostile environment for pregnancy development. In cases where hydrosalpinx is unilateral, the other tube may remain functional and offer a slight chance of natural conception. However, even in such cases, the chances are significantly lower compared to healthy reproductive organs.

Risks & IVF Success Rates

Hydrosalpinx also affects the success rates of in vitro fertilization (IVF). Studies have shown that the presence of fluid in the tube can hinder embryo implantation in the uterus, even when embryo transfer is successful. This happens because the fluid may reflux into the endometrial cavity, creating a toxic and unfavorable environment for the embryo. According to studies, untreated hydrosalpinx can reduce IVF success rates by 50%. For this reason, removal or isolation of the affected tube is recommended before starting IVF treatment, either through laparoscopic salpingectomy or by blocking the distal end of the tube. Proper intervention significantly improves prognosis and offers higher success rates per IVF cycle, giving many women the opportunity to become mothers.

Treatment Options

Treating hydrosalpinx requires a targeted and personalized approach depending on the extent of the damage, the patient’s age, overall fertility, and reproductive plans. Modern treatments focus either on surgical repair of the tube or its removal to restore fertility through IVF.

Treatment 1

Laparoscopic Salpingectomy

Laparoscopic salpingectomy is the most common and effective treatment method for severe hydrosalpinx. During the procedure, the affected tube is completely removed via minimally invasive surgery. This technique reduces the risk of inflammation, eliminates the presence of toxic fluid, and significantly increases success rates in upcoming IVF cycles. The laparoscopic approach offers benefits such as shorter hospital stay, faster recovery, less postoperative pain, and lower risk of complications.

Treatment 2

Salpingostomy / Anastomosis

In some cases where damage is not extensive, it may be possible to restore the tube via salpingostomy or anastomosis. In salpingostomy, an artificial opening is created at
the end of the tube to allow fluid drainage, while in anastomosis, the healthy segments of the tube are reconnected after removing the damaged portion. These techniques are selectively applied, mainly in women desiring natural conception and without severe tubal deformation. They require detailed preoperative evaluation and are not suitable for all cases, as success rates remain limited compared to IVF.

Treatment 3

IVF after Treatment

In vitro fertilization (IVF) is the main reproductive option for women with hydrosalpinx, especially when the tubes have been removed or deemed non-functional. After surgical treatment, IVF can proceed without fluid interference in the uterus, significantly increasing the chance of successful implantation and pregnancy. Preparation for IVF after salpingectomy includes hormonal stimulation, egg retrieval, fertilization in the lab, and embryo transfer to the uterus. The absence of hydrosalpinx plays a critical role in creating a stable, healthy environment for the embryo.

Frequently Asked Questions About Hydrosalpinx

How much does hydrosalpinx affect implantation chances after embryo transfer?

Hydrosalpinx can significantly reduce successful implantation rates, even with high-quality embryos. Fluid from the tube may enter the uterus and alter the endometrial environment, making it hard for the embryo to attach to the endometrium.

What is the ideal time to start IVF after salpingectomy?

Most women can begin an IVF cycle 1 to 2 months after salpingectomy, once recovery is complete and tests show the uterus is ready for implantation. The reproductive gynecologist will determine the right timing based on your history and lab results.

Are there non-invasive treatments for hydrosalpinx?

Unfortunately, non-invasive options are of limited effectiveness. Medication cannot restore the anatomy or function of blocked tubes. Surgery remains the most effective solution in hydrosalpinx cases.

Can hydrosalpinx be detected during egg retrieval?

Hydrosalpinx is not diagnosed during egg retrieval, as the procedure concerns removing eggs from the ovaries, not examining the tubes. However, its presence can be suspected from earlier ultrasound scans conducted before IVF.

Is there a way to prevent hydrosalpinx?

The best prevention is the timely treatment of reproductive tract infections, especially sexually transmitted diseases, which can cause inflammation in the tubes. Regular gynecological check-ups and condom use reduce the risk of developing hydrosalpinx.

Does hydrosalpinx affect ovarian function?

Hydrosalpinx does not directly affect the ovaries or egg production. However, in some cases of extensive adhesions or severe inflammation, ovarian accessibility or function may be limited during egg retrieval.

Our Doctors

In an era where fertility requires knowledge, care, and substantial guidance, FertUlity is not an impersonal clinic. It is two people who look you in the eye and accompany you step by step on the journey you dream of.

Dr. Maria Oikonomou Obstetrician – Gynecologist

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Dr. Chrysostomos (Makis) Papadopoulos Obstetrician – Gynecologist, MD, PhDc, MIC I

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