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Hydrosalpinx: what are hydrosalpinges?

Hydrosalpinx is a condition in which fluid gathers in one or both Fallopian tubes and cannot escape due to the fact that the end of the tube is blocked. The tube then takes on the appearance of a balloon filled with fluid.

This condition is caused by infection of the tubes which produces a stickiness of the delicate structures whose job it is to gather up the egg that has been ovulated and encourage it into the tube. As the tube constantly produces fluid that nourishes the egg on its way to the uterus, once the end of the tube is blocked, the egg cannot enter but the fluid continues to gather.

Hydrosalpinx also indicates irreparable damage to the wall of the tube which usually becomes thinner and so the tube loses its functional capacity.
Hydrosalpinx may be diagnosed by an x-ray of the uterus and tubes (hystero-salpingogram; HSG) in which liquid is injected from below into the uterus and shows up on the x-ray.

A hydrosalpinx is diagnosed when the injected fluid gathers in the tube in large amounts and cannot escape. More often, hydrosalpinx is diagnosed on ultrasound examination. Even when seen on one side only, a hydrosalpinx will often indicate damage to the second tube.

Hydrosalpinx is an obvious cause of tubal, mechanical infertility. Although surgical opening of the tube and release of the trapped fluid is possible, it is doubtful that this will relieve the infertility as irreparable damage to the function of the tube has usually already occurred. IVF is the recommended treatment in order to bypass the tubes.

The results of IVF in this condition are greatly improved when the damaged tubes are surgically removed by laparoscopy. This may be done before IVF is attempted or after 1-2 failed cycles. It is thought that the fluid from the tubes leaks into the cavity of the uterus and has a toxic effect on the embryo and the lining of the uterus which reduces the chance of a successful pregnancy.

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