Hydrosalpinx and infertility

Hydrosalpinx is one of the diseases that is diagnosed in a large percentage of women and causes infertility. The fallopian tubes, like the uterus and ovaries, play an important role in the reproductive process and, by extension, in achieving pregnancy. The functionality of the fallopian tubes is essential as through them the egg is transferred inside the uterus and fertilization is achieved in its lumen by the moving sperm. Therefore, any pathology of the fallopian tubes has a great impact on female fertility.

What is the hydrosalpinx?

The fallopian tubes are small ducts through which the eggs are transported from the ovaries to the uterus. Partial or complete blockage of the opening of the fallopian tube – usually the one near the ovary – causes the accumulation of serum or clear fluid. The fluid collected due to the obstruction is called peritoneal fluid and causes the fallopian tubes to dilate. This pathological condition is called hydrosalpinx and causes serious infertility problems.

What are the causes of hydrosalpinx?

Hydrosalpinx can be caused by various etiological factors. In the majority of cases, its manifestation is a result of pelvic inflammatory disease. Pelvic inflammatory disease is mainly caused by untreated sexually transmitted diseases and is responsible for the onset of chronic inflammation, which in turn may cause hydrosalpinx. In addition, hydrosalpinx can be a result of the following causes:

• Endometriosis
• Accidental fallopian tube injury due to previous surgery
• Congenital anatomical anomalies in the fallopian tubes
• Previous ectopic pregnancy
• Manifestation of inflammation due to appendicitis
• Formation of scar tissue due to previous surgery on the pelvis or fallopian tubes

Of course, there are not a few cases where it is not possible to identify the cause of hydrosalpinx (idiopathic hydrosalpinx).

What are the symptoms of hydrosalpinx?

In the majority of cases, hydrosalpinx is asymptomatic, although its impact on fertility is great. Thus, the hydrosalpinx is usually identified in the context of investigating the causes of infertility. However, in cases of patients who manifest symptoms, the main symptom of hydrosalpinx is abdominal or pelvic pain. This pain may be accompanied by unusual vaginal discharge.

Hydrosalpinx and infertility: How does hydrosalpinx affect female fertility?

The contribution of the fallopian tubes to the proper functioning of the reproductive system is great. Therefore, the existence of a hydrosalpinx does not favor the normal development of the fetus, causing conditions such as:

• Failure to fertilize the egg or failure to transfer the fertilized egg to the uterus.
• Causing an ectopic pregnancy (development of the fetus inside the fallopian tube).
• Secretions from the hydrosalpinx that may end up in the uterus, causing unfavorable conditions for the embryo to implant.
• Secretions that may be toxic to the fetus.

At this point, it should be mentioned that the hydrosalpinx also makes it difficult to get pregnant through IVF. The toxic environment that may have been caused due to the hydrosalpinx inside the uterus negatively contributes to the implantation of the fertilized egg. Furthermore, the hydrosalpinx can also affect the quality of the eggs, making the process of assisted reproduction even more difficult.

In what ways can infertility caused by hydrosalpinx be treated?

Treatment of hydrosalpinx should be immediate after its detection to achieve pregnancy. Even in cases where a pregnancy is achieved despite the presence of hydrosalpinx, the chances of miscarriage are high.

A hydrosalpinx is treated exclusively laparoscopically and the type of operation depends on the dilatation of the fallopian tube, as well as the patient’s medical history. In particular, there are two surgical procedures to treat hydrosalpinx, salpingostomy and salpingectomy. The salpingostomy is applied to the fallopian tubes with a small distension and refers to the opening of the hydrosalpinx. On the contrary, in highly dilated fallopian tubes, a salpingectomy is applied, in which all or part of the affected fallopian tube is removed.

The Obstetrician-Gynecologist Melina Stasinou has extensive experience in assisted reproduction methods. Besides her vast experience, what distinguishes her is her empathy and her goal is to help women experience motherhood. Contact us for any question you may have about how hydrosalpinx affects female fertility and possible ways to treat it.