Blocked fallopian tubes (hydrosalpinx) – Efferty

A hydrosalpinx is a fluid blockage in your fallopian tubes that can make it difficult to become pregnant. A hydrosalpinx can be caused by damage from your fallopian tubes, most commonly from an untreated illness. Draining and repairing the tubes or removing them (salpingectomy), are the treatments. After treating a hydrosalpinx, many individuals and couples who want to conceive a baby choose IVF.

What is hydrosalpinx?

The condition hydrosalpinx happens when fluid accumulates in one or both fallopian tubes, causing a blockage. The fallopian tubes extend from your uterus to your ovaries. Your ovaries create an egg that travels through your fallopian tubes each month as part of your menstrual cycle. A healthy fallopian tube provides an open passageway for an egg and sperm to unite (fertilize). The fertilised egg, or embryo, travels to your uterus through the same open channel. An embryo can then implant in your uterine wall and develop into a fetus.

With a hydrosalpinx, fluid buildup blocks this passageway. Sperm may not reach your egg if your fallopian tube is blocked. If fertilization occurs, the embryo may be prevented from reaching your uterus due to a blockage in your fallopian tube.

How common is hydrosalpinx?

Twenty to 30% of infertility cases involve issues with the fallopian tubes (tubal factor infertility). Hydrosalpinx is present in 10% to 20% of these cases.

How does hydrosalpinx affect my body?

Untreated hydrosalpinx can make pregnancy difficult and increase your risk of miscarriage and pregnancy complications. In addition to making it harder to become pregnant through intercourse, hydrosalpinx can:

Increase your chances of having an ectopic (tubal) pregnancy: Because of a blockage, an embryo that is unable to reach your uterus may implant in your fallopian tubes, resulting in an ectopic pregnancy. These pregnancies are not viable and can be fatal if not treated.
Decrease your chances of becoming pregnant through in vitro fertilizations (IVF): IVF can help you become pregnant even if you don’t have fallopian tubes. Using IVF, your provider collects your eggs and fertilises them outside of your body using sperm from your partner or a donor. The embryo is then transferred into your uterus, where it can develop. Once the embryo implants into your uterine wall, a hydrosalpinx might create problems. According to research, fluid from a hydrosalpinx can flow backwards into your uterus, creating an unhealthy environment for a developing embryo.

Treating hydrosalpinx increases your chances of a healthy pregnancy, even if you opt for IVF.

Symptoms and Causes

What are the signs and symptoms of a hydrosalpinx?

Hydrosalpinx rarely produces symptoms. You may not realise your tubes are blocked until your doctor checks what’s making it difficult for you to become pregnant.

When symptoms are present, they are as follows:

Pelvic pain that may happen during or immediately following your period
Discolored and/or sticky vaginal discharge

What causes a hydrosalpinx?

The most common cause of hydrosalpinx is an untreated infection. Harmful bacteria can inflame and cause damage to your fallopian tubes. This inflammation frequently occurs in the fallopian tube near your ovaries, known as the fimbriae. Fimbriae are finger-like extensions of your ovaries that sweep an egg into your fallopian tubes.

Your fimbriae may fuse together as part of the healing process, sealing your fallopian tubes. Fluid trapped within your tubes, causing them to swell.

The following are some of the causes of hydrosalpinx:

Untreated sexually transmitted illnesses (STIs) such as chlamydia and gonorrhoea
Pelvic inflammatory disease (PID), which is frequently caused by untreated STIs,
Scar tissue from pelvic surgery, particularly surgery on your fallopian tubes.
Tissue buildup from endometriosis
Some tumors.

Diagnosis and Tests

What tests will be done to diagnose a blocked fallopian tube?

Tests to see if your fallopian tubes are blocked include:

Ultrasound: Your fallopian tubes are normally not visible on an ultrasound. However, if they are swollen due to fluid buildup, they will appear larger than usual. They are sometimes shaped like sausages. Your doctor can order more tests to determine that the change is due to a hydrosalpinx.
HSG (Hysterosalpingogram): An HSG is an X-ray dye test used to detect fallopian tube blockages. It is the most commonly used test to diagnose hydrosalpinx. Your doctor will introduce a dye medium into your uterus and use an X-ray to monitor its movement. Your tubes are open if the dye leaks out of them and into your pelvic cavity. If the dye stops flowing, your tubes are clogged.
Laparoscopy: A laparoscopy is a minimally invasive surgery that allows your doctor to see into your abdomen cavity. They make tiny cuts into your belly and insert a small camera (laparoscope) inside to examine your fallopian tubes. To check for blockages, they may insert a catheter into your vagina and cervix and pump dye into your uterus and fallopian tubes. Laparoscopy can be performed to validate HSG results.

Management and Treatment

How is hydrosalpinx treated?

Treating hydrosalpinx can increase your chances of becoming pregnant. Your treatment will be determined by factors such as the severity of your blockage and your age.

If you have an active infection, your doctor will prescribe medicines to treat it. Surgical procedures include:

Salpingectomy is the surgical removal of one or both fallopian tubes (bilateral salpingectomy).
Salpingostomy (neosalpingostomy): This procedure repairs a blockage in your tubes. Laparoscopy is commonly used to perform a salpingostomy. To drain your fallopian tube, your doctor makes a small incision into it with a salpingostomy. Your doctor can remove the damaged part of the tube and reopen the ends that have been sealed shut. In recent years, the outcomes related to salpingostomy have made it a less popular alternative than IVF. Following this surgery, your chances of miscarriage and pregnancy difficulties may increase. IVF has a higher pregnancy success rate than salpingostomy.

Many people and couples who are trying to have a baby are treated for hydrosalpinx and then undergo IVF, which bypasses the fallopian tubes entirely. Depending on your needs, your doctor can advise you on the best solutions.

How do you get rid of hydrosalpinx naturally?

There are no natural hydrosalpinx treatments. If your tubes have just minor damage, your doctor may be able to repair them using a salpingostomy. For more severe hydrosalpinx, one or both fallopian tubes may need to be removed.

Prevention

How can I reduce my risk of a hydrosalpinx?

The best way to avoid hydrosalpinx is to reduce your risk of getting an STI. Practicing safer sex can decrease the odds of an infection that may harm your reproductive organs.

Outlook / Prognosis

What happens if hydrosalpinx is left untreated?

Untreated hydrosalpinx lowers your odds of becoming pregnant while also increasing your risk of miscarriage and problems such as ectopic pregnancy. Receiving treatment increases your chances of having a healthy pregnancy.

Is hydrosalpinx life-threatening?

Hydrosalpinx is not fatal on its own, but it can increase your risk of ectopic pregnancy, which can be fatal if not treated.