Hydrosalpinx: Symptoms, Treatment, and More

 

 

What is Hydrosalpinx?

Hydrosalpinx is a blockage in a fallopian tube due to a watery fluid. In order to understand the term we will break it down into two parts; “hydro” means water and “salpinx” means a fallopian tube. This condition is mainly caused because of certain reasons such as pelvic or sexually transmitted infection or previous surgery. 

 

Some women do not face any symptoms, however, others may experience frequent pain in the lower abdomen and could have also abnormal vaginal discharge. Generally, in all cases, this condition can have negative effects on a woman’s fertility. 

How does Hydrosalpinx Affect Fertility?

In order to get pregnant, a sperm and an egg must meet so the fertilization could take place. Around day 14 of a woman’s menstrual period, the ovary releases an egg that travels down to the uterus waiting for the sperm to fertilize it. If there is a blockage in a tube or more, the egg won’t be able to travel down to the uterus and pregnancy will not happen. 

What Happens, If Only One Tube is Blocked?

In general, the monthly egg is not being released from the same ovary. Occasionally, for some women, an egg could be released from both sides in the same month. If only one fallopian tube is affected by hydrosalpinx and the other is not, pregnancy can take place. By way of example, damage in a fallopian tube can lead to fluid leakage inside the uterus during pregnancy. Scientists have not determined the reason why is that fluid causing issues, but recent studies say that hydrosalpinx can have negative effects on the blood flow inside the uterus. 

What are the Symptoms of Hydrosalpinx?

 

There are different causes for Hydrosalpinx and the symptoms can vary depending on the woman’s own condition. Some women do not experience any symptoms, however, hydrosalpinx can affect fertility negatively. 

Symptoms

Symptoms of hydrosalpinx may include the following:

  • Abnormal vaginal discharge
  • Abdominal and pelvic pain

 

However, in some cases, women could have hydrosalpinx without experiencing any symptoms. Seeing that, hydrosalpinx negatively affects fertility, many women only find out they have the condition when trying to conceive a baby. 

 

Hydrosalpinx Diagnosis

There are several methods that can help the doctor diagnose hydrosalpinx. Including the following: 

  • An ultrasound: this is one method of checking for hydrosalpinx, but it is not that effective.
  • A sonohysterosalpingography: Saline fluid and sterile air are inserted through a woman’s cervix and into the uterus. Then a transvaginal ultrasound is used in order to check the reproductive organs and detect whether there is a blockage.
  • Laparoscopy: Also called keyhole surgery, it is a surgical procedure where small incisions are done in the abdomen, and a tiny camera is inserted. This procedure helps the surgeon to view the organs and remove fluid or other issues.
  • Hysterosalpingogram (HSG) is a type of X-ray that can show tubal blockages. In addition to a special dye is inserted through the vagina and cervix.

Hydrosalpinx and Infertility

At the time of conception, the egg travels from an ovary through the fallopian tubes into the uterus where is stays and waits to be fertilized by sperm. Hydrosalpinx caused blockage in the fallopian tube(s) due to the fluid, so it makes it impossible for the egg can not go down the fallopian tube(s). 

In addition to this, the fimbria that helps to pull the egg from the ovary through the fallopian tubes can get stuck together. If there is a blockage in one fallopian tube, there will still be a potential to conceive without any intervention, as eggs from the other ovary will be able to make the journey through the uterus and wait for the sperm to fertilize it. Not to mention, there is also a chance that the fluid buildup could cause some leakage into the uterus which could prevent the embryo from implanting itself perfectly. 

Treatment and Management

The most common treatment for women with hydrosalpinx is surgery whereas the affected or blocked tube gets removed. This surgery is known as salpingectomy. Surgery can also be an option to remove scar tissue or other adhesions that could negatively affect fertility. 

If the cause is endometriosis, doctors can remove the endometrial growths as well. Many women with hydrosalpinx choose to operate in vitro fertilization (IVF) treatment when trying to get pregnant. 

If IVF treatment is done before surgery in order to remove the affected tube, chances of getting pregnant are decreasing. Therefore, it is recommended to complete surgery before undergoing IVF treatment to make sure the result has the biggest chance of success.

 

Sclerotherapy is another treatment option, where an ultrasound-guided needle is used to extract fluid out of the damaged tube. Then a special chemical is injected in order to prevent the fluid from developing again. 

What other treatment options are available?

Repairing the blocked tube(s)

Repairing the blockage in tubes can play a key role. There is a procedure known as laparoscopic salpingostomy where the affected tube is opened to draw the fluid by a small incision. Then the tube is clipped to prevent any fluid from causing leakage into the uterus. This procedure could save the tube, however, it is not recommended because the fluid can develop again. 

In Vitro Fertilization after treatment

After treatment, women should discuss with their doctor if they should undergo in vitro fertilization in order to conceive a baby. The IVF usually requires around 14 days to complete every cycle. The first thing to do is taking injectable hormones and medications to mature the eggs, block premature ovulation as well as preparing the lining of the uterus. 

A couple of days right after the last injection, the doctor will retrieve the woman’s eggs. Therefore, an ultrasound is used to direct a tiny needle to remove the eggs. After removing the eggs, they are fertilized by sperm to create an embryo. This procedure can be done whether by using the male partner’s frozen or fresh sperm. Then the fertilized embryo is transferred into the woman’s uterus by using a catheter (a tiny thin needle) so that it can develop and grow. 

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