Hydrosalpinx – How Blocked Fallopian Tubes affect Female Fertility

You may have heard people talking about ‘blocked tubes’ when they explain their female fertility problems. If a fallopian tube blockage is located at the distal end of the fallopian tube, which is located furthest from the uterus, and if the fallopian tube is distended by fluid that has accumulated within the tube as a result, the medical term for this is hydrosalpinx, which is often diagnosed during investigations into female fertility concerns. Although some women do experience symptoms from hydrosalpinx, others only learn there is a problem when they have investigations as a result of difficulties conceiving. If you’d like to learn more about this condition, and how it impacts female fertility, then read on.

What is Hydrosalpinx?
The fallopian tubes are also known as the salpinges. The term hydrosalpinx is used to refer to fluid-filled fallopian tubes that result from distal tubal blockage. A hydrosalpinx can cause abdominal pain or unusual vaginal discharge, but it’s not uncommon for women to be completely unaware they have the condition until it is discovered during fertility investigations.

How does Hydrosalpinx affect Female Fertility?
During ovulation, the ovary releases the egg which is captured by the fimbriae of an open fallopian tube and travels down to the fallopian tube to the uterus where it can be fertilized. If the tubes are blocked, then it is difficult or impossible for the egg to make that journey, leading to impaired fertility.

Risk factors for Hydrosalpinx
Although anyone can develop this condition, it is more common for women who have experienced one or more of the following:
• Endometriosis
• Sexually Transmitted Disease (STD)
• Pelvic Inflammatory Disease (PID)
• Abdominal and/or Pelvic Surgery

How is Hydrosalpinx diagnosed?
There are a number of different ways in which a diagnosis can be reached, these are:
• Ultrasound – Regular ultrasounds don’t always pick up hydrosalpinx.
• Hysterosalpingogram (HSG) – This procedure involves introducing dye through the cervix to highlight the uterine cavity and fallopian tube anatomy and then taking a series of x-rays.
• Laparoscopy – A diagnostic laparoscopy allows your doctor to perform a direct visual check for hydrosalpinx, along with other conditions which may be impacting female fertility such as endometriosis or PCOS.

Treatment for Hydrosalpinx
Most commonly, women with hydrosalpinx are offered treatment to remove the affected tube.
Where endometriosis or PID are found to be the cause, then treating those conditions will be helpful; for example, endometrial growths can be removed surgically to improve the chance of conception.

It is common for women with hydrosalpinx to choose to use in vitro fertilization (IVF) in order to maximize their chances of conceiving. If you do choose to have IVF, then it improves your chances of conception if you have the damaged tube removed first.

Doctor Shahryar Kavoussi explains that surgery is helpful, “in order to optimize pregnancy rates and minimize miscarriage rates.” Dr Kavoussi also offers hope for those with both tubes affected, “If both fallopian tubes are hydrosalpinges, then the recommendation is to remove both hydrosalpinges and then proceed with IVF for the opportunity to achieve a successful pregnancy.”

Living with Hydrosalpinx
It is still possible for women with hydrosalpinx to get pregnant naturally; however, in the less likely event of pregnancy when a hydrosalpinx is present, there is an increased risk of complications such as ectopic pregnancy, and of miscarriage among these pregnancies. Treatment of the problem before carrying out IVF increases your chances of a successful pregnancy.