All About Hydrosalpinx, a Type of Fallopian Tube Blockage

Medically Reviewed By Amanda Kallen, MD
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Hydrosalpinx is a condition where one or both of the fallopian tubes are blocked with fluid. This can result in reproductive complications. The fallopian tubes are an important part of the female reproductive system. They transport the egg from the ovaries to the uterus. The tubes are where fertilization occurs. Fertilization is when the egg and sperm fuse together to form an embryo. The embryo travels through the fallopian tube into the uterus. It attaches to the uterine wall and develops into a fetus.

Hydrosalpinx can block the passage of the egg, and the fluid itself may be toxic to the embryo. Together, this prevents the sperm from reaching the egg. It also prevents the fertilized egg from moving from the ovary to the uterus to be implanted. This can result in infertility or ectopic pregnancy.

Additionally, hydrosalpinx impairs implantation even if the embryo is in the uterus, such as with in vitro fertilization (IVF). This is fertilizing eggs with sperm in a laboratory and transferring embryos to the uterus.

Hydrosalpinx can have a significant impact on fertility and quality of life. This article will discuss hydrosalpinx, its causes, symptoms, diagnostic procedures, treatments, and more.

Sex and gender exist on spectrums. This article will use the terms “female” and “women” when discussing people assigned female at birth to reflect language that appears in source materials.

Learn more about the difference between sex and gender here.

What is hydrosalpinx?

pregnant woman on her bed using laptop with shadows on the wall from incoming sunlight
Eloisa Ramos/Stocksy United

Hydrosalpinx is the presence of fluid in the fallopian tube. It may occur only in certain areas of the tube, but it can also involve the entire tube.

The far end of the fallopian tube has small, fingerlike projections known as fimbriae. A fertilized egg moves from the ovaries through fimbriae to the uterus to be implanted in the uterine wall.

Unilateral hydrosalpinx involves one tube, whereas bilateral hydrosalpinx involves both tubes. Bilateral hydrosalpinx completely obstructs fertility.

What causes hydrosalpinx?

The most common cause of hydrosalpinx is pelvic inflammatory disease (PID), which causes scarring. Sexually transmitted infections (STIs), usually chlamydia or gonorrhea, can cause PID. Without treatment, these infections can lead to chronic inflammation in the fallopian tube(s). This causes fluid to accumulate inside, causing obstruction.

Risk factors

Other factors that can result in hydrosalpinx are:

  • endometriosis
  • appendicitis
  • history of ectopic pregnancy
  • prior surgery that affects the fallopian tubes or other nearby organs
  • other causes of infection that affect the reproductive system

What are the symptoms of hydrosalpinx?

Hydrosalpinx is generally asymptomatic, which means there are no symptoms. When symptoms are present, the most common complaint is pain in the pelvic region.

Many women with hydrosalpinx do not know of it until they seek help for fertility problems. Aside from tubal factor infertility, symptoms may include fever, unusual vaginal discharge, and worsening of pain during and after menstruation.

Tubal factors account for approximately 25% of infertility. Hydrosalpinx is the most severe form and accounts for 10–30% of tubal factor infertility cases. Tubal factors include blocked fallopian tubes and pelvic scarring, which can prevent the tubes from accepting the egg.

Additionally, hydrosalpinx can lower the chance of pregnancy by in vitro fertilization (IVF).

Learn about female infertility causes here.

How do you diagnose hydrosalpinx?

If your doctor suspects you have blocked fallopian tube(s), they may perform one or more of these tests:

  • Hysterosalpingogram: This is an X-ray of the fallopian tubes with a contrast dye. The doctor inserts a thin catheter through your cervix and into your uterus. They then inject the dye, which creates clearer X-ray images.
  • Sonohysterogram: For this ultrasound exam, the doctor instills fluid with contrast into your uterus. The fluid helps illuminate the area so the doctor gets more detailed images of your uterine lining.
  • Laparoscopy: This is minimally invasive surgery to evaluate abdominal organs, including the female reproductive organs. To evaluate the fallopian tubes, the surgeon introduces a dye into your uterus to see if it flows out of the fallopian tube(s). Learn about pelvic laparoscopy here.

How do you treat hydrosalpinx?

The cause, severity of the condition, and whether you want to conceive play a part in hydrosalpinx treatment options. Below is a summary of different hydrosalpinx treatments, according to the American Society of Reproductive Medicine (ASRM).

  • Salpingostomy: This is laparoscopic surgery to unblock the fallopian tube. This procedure may be suitable for mild hydrosalpinges. The fallopian tube remains intact.
  • Salpingectomy: This is removal of the fallopian tube. It may be a laparoscopic surgery or an open procedure, which is when the surgeon makes a larger incision in the abdomen to view the area directly. IVF is required for pregnancy if both tubes are removed.
  • Sclerotherapy: Using ultrasound as a guide, this procedure instills ethanol into the fallopian tube. This limits its ability to produce fluid. It may also prevent the recurrence of hydrosalpinx. This procedure may be done during IVF to increase the chance of implantation.
  • Ultrasound-guided aspiration: This procedure removes the fluid from the tube. Clinicians have investigated the use of hydrosalpinx ultrasound aspiration at the embryo transfer step of IVF. It appears to have variable effects on the rate of pregnancy with IVF, according to the ASRM.

What is the outlook?

It is still possible to get pregnant with hydrosalpinx in one tube. However, hydrosalpinx may affect your uterus as well, reducing the likelihood of pregnancy.

Hydrosalpinx treatment increases the likelihood of pregnancy, especially with IVF, according to a 2019 meta-analysis of 14 studies.

Research suggests that both salpingectomy and sclerotherapy have similar success rates when combined with IVF. However, the ASRM suggests more research on sclerotherapy is necessary because there is evidence it can worsen the blockage and hydrosalpinx.

Fallopian tube surgery is not limited to people with fertility concerns. It also addresses the underlying cause of hydrosalpinx, such as infection, and improves symptoms, such as pelvic pain.

Other frequently asked questions

Amanda Kallen, M.D., reviewed the following frequently asked questions.

Is hydrosalpinx serious?

Hydrosalpinx impacts one or both fallopian tubes. Hydrosalpinges, which involves both tubes, is a severe form of tubal damage, and pregnancy is usually only possible with IVF. Additionally, ectopic pregnancy may occur, which can be life threatening.

Can you leave hydrosalpinx untreated?

Hydrosalpinx may not need treatment if it is not causing health problems or affecting your fertility, if you plan to conceive. Your physician can evaluate these effects. Hydrosalpinx can make it more difficult to conceive a child naturally and by IVF.

Are there natural treatments for blocked fallopian tubes?

The only natural treatment is watchful observation, depending on the clinical findings and symptoms. One small comparative study looked at pregnancy rates before and after a physical therapy technique in females with infertility and blocked fallopian tubes. However, there were no control participants, or those without fallopian tube blockage. There is significant bias because the practitioners are selling the protocol as a possible therapy.

Summary

Hydrosalpinx is a condition where one or both fallopian tubes are blocked and filled with fluid. The most common cause is PID. Hydrosalpinx can result in reproductive issues, such as infertility and ectopic pregnancy.

Hydrosalpinx treatment options include surgery to clear the blockage or remove the fallopian tube. Studies show that hydrosalpinx treatment increases pregnancy rates. IVF may be an option if treatment does not restore fertility.

If you have hydrosalpinx, your physician can guide you through the options based on your specific circumstances.

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Medical Reviewer: Amanda Kallen, MD
Last Review Date: 2022 Aug 8
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