Hydrosalpinx: Causes, Symptoms, & Impact on Fertility & IVF

What Is Hydrosalpinx?

In women, the fallopian tubes play an important role in fertilisation. They’re responsible for carrying eggs from the ovaries to the uterus. In a hydrosalpinx, the fallopian tubes get blocked due to fluid accumulation. When fluid fills the tube, it can obstruct the natural passage of the egg, preventing sperm from meeting the egg for fertilisation. Unfortunately, this blockage can make natural conception very difficult and may also affect IVF outcomes if left untreated. Understanding hydrosalpinx is the first step in addressing fertility challenges associated with blocked fallopian tubes.

Causes of Hydrosalpinx

A hydrosalpinx usually develops when an infection goes untreated. The bacteria cause inflammation and damage in the fallopian tubes, especially near the fimbriae (the tiny finger-like ends that help guide an egg from the ovary). During healing, these fimbriae can stick together and block the tube, trapping fluid inside and making it swell. Some general hydrosalpinx causes are mentioned below:

• Endometriosis : Endometriosis causes uterine tissue to grow on the ovaries, fallopian tubes, or pelvic lining, etc. This can cause inflammation and scarring and sometimes block the fallopian tubes, making it harder to get pregnant.
• History of surgery on the fallopian tubes : Surgery may cause scarring or cause an infection, blocking the fallopian tubes.
• Infections affecting the fallopian tube : Any infection that occurs in the fallopian tubes can cause fluid buildup that can lead to swelling and blockage.
• Inflammation caused by appendicitis : Appendicitis, an inflammation of the appendix, can sometimes irritate nearby organs, including the fallopian tubes. This inflammation can lead to scarring or blockage of the tubes.
• Past pelvic/abdominal surgery : Any surgery in the pelvic or abdominal area, such as for cysts, fibroids, or other conditions, can cause scar tissue. Scar tissue can stick to the fallopian tubes, sometimes causing blockages.
• Pelvic inflammatory disease (PID) : The most common cause of the far end of the fallopian tube getting blocked is pelvic inflammatory disease (PID), often caused by infections like chlamydia or gonorrhea that move up from the vagina. But not every pelvic infection will lead to this kind of blockage.
• Sexually transmitted infections (STIs) : STIs are one of the most common hydrosalpinx or blocked fallopian tubes causes. The most common of these infections include chlamydia, gonorrhoea, etc. These infections, when left untreated, can spread to other parts of the reproductive tract and can even affect the fallopian tubes, causing hydrosalpinx.
• Tuberculosis : In rare cases, tuberculosis can affect the reproductive organs. When it reaches the fallopian tubes, it can cause inflammation and blockages, affecting fertility. Tubal tuberculosis is a rare cause of hydrosalpinx formation.

How does Hydrosalpinx Affect Fertility and IVF?

Fallopian tubes connect the ovaries to the uterus and play a key role in helping pregnancy happen naturally. After ovulation, they gently pick up the egg, provide a safe place for it to meet the sperm, and then guide the fertilised egg toward the uterus. They even supply the right nutrients along the way. When the tubes are blocked or damaged, this natural process can be affected, making it harder to conceive. Consequently, hydrosalpinx can affect fertility and IVF in the following ways:

• Fluid in the tubes blocks the egg from meeting the sperm, and hence, natural conception becomes difficult.
• These blockages not only prevent the egg from meeting the sperm but can also make it harder for embryos to travel to the uterus, resulting in ectopic pregnancies.
• When fluid collects in the fallopian tubes due to hydrosalpinx, it can sometimes leak into the uterus. This leaked fluid can disturb the natural balance inside the womb and make it harder for an embryo to attach and grow. It may also contain substances that affect the lining of the uterus or harm developing embryos.
• Women with blocked fallopian tubes or hydrosalpinx, unfortunately, will have less success with IVF. Blocked tubes will eventually cause issues with ovulation. Leaking fluid will make it harder for the embryo to attach to the uterine lining. All these factors will reduce the chances of a successful IVF transfer.

Treatment Options for Hydrosalpinx

Thankfully, there are treatment options available for hydrosalpinx. These include mostly surgical interventions. Medicines can help with recovery, but cannot completely remove the blockages on their own.

• Salpingectomy : It refers to the surgical removal of the affected tube and is considered the most effective option, especially for women planning IVF. Removing the damaged tube prevents harmful fluid from leaking into the uterus, significantly improving embryo implantation and pregnancy rates.
• Salpingostomy : This involves creating a new opening in the blocked tube to restore its function. While it can allow natural conception, there is a higher risk of recurrence, and the success rates are generally lower than with full tube removal.
• IVF after surgery : It is always recommended for women with hydrosalpinx to first treat the condition, possibly with surgery, and then opt for IVF. Studies show that hydrosalpinx IVF treatment considerably improves the pregnancy success rates when the damaged tube is removed before the procedure, giving embryos a healthier environment to implant.
• Antibiotics : Depending on the severity of the infection, oral or intravenous antibiotics may be prescribed if there is an active infection, but they cannot cure the blockage itself.

Effective hydrosalpinx treatment is key to improving fertility and increasing the chances of a successful pregnancy, and working with a fertility specialist ensures the approach is tailored to your individual needs. Surgical interventions may seem scary, but they are entirely safe. Do talk to your doctor to understand the pros and cons of your treatment plan.

Conclusion

Hydrosalpinx may sound like a very complicated medical condition, and women who are trying to conceive may in particular fear it. However, the swelling and blockages of the fallopian tubes may have several causes, and most of the time, it is treatable with simple interventions.

Studies show that IVF success rates and pregnancy outcomes improve significantly after treatment, sometimes nearly doubling compared to women who undergo IVF without addressing the hydrosalpinx. Treating the condition before attempting IVF gives the best chance for a successful pregnancy.