What is hydrosalpinx? 

Sometimes, the Fallopian Tubes (the tubes remaining on both sides of the the uterus, where the sperms and the eggs meet to form the embryo) become swollen and contains fluid. This condition is called hydrosalpinx. 

What are the reasons for hydrosalpinx?

The most common reason is PID (Pelvic Inflammatory Disease), where sexually transmitted infection (STI) can damage the tube and block it. As a result, the secretions accumulate inside the tube. Another reason is endometriosis (the lining of the uterus may lie outside the uterus and causes blockage of the tube). Previous surgery, infections like tuberculosis may also be responsible. 

How hydrosalpinx is harmful? 

In hydrosalpinx the inner lining of the tube is damaged. Usually hydrosalpinx is associated with blockage of the tube, so that the egg and the sperm cannot meet properly. Even if the tube is found open by HSG, because of the damage of the inner lining, the tube cannot function properly and as a result, the embryo is not formed inside the tube. 

In case, a woman requires IVF, the fluid present in the hydrosalpinx, leaks inside the uterus and damages the embryo and thus leads to failure of IVF treatment.

How hydrosalpinx is diagnosed?

Sometimes HSG can show small hydrosalpinx. If it is not shown in the TVS, in most cases, nothing special is required. However, if the TVS shows hydrosalpinx, the damaged Fallopian tube must be REMOVED, because this tube IS DOING MORE HARM THAN BENEFIT.

How hydrosalpinx is removed?

The ideal procedure is laparoscopy, where by means of key-hole surgery, the diseased tube is removed (Salpingectomy). However, in some cases, it may not be possible, technically, to remove the tube. In that case, the tube is blocked by special clip.

What should be done if both the tube contains hydrosalpinx?

In that case, both the tube should be removed. But, unfortunately, in that case, the only option remaining for pregnancy, is IVF. 

What should be done if hydrosalpinx is seen during or before IVF? 

In that case, it's better to remove the tube after egg collection (and freezing the embryos), so that the effect of surgery on ovaries can be minimised (there is small chance of ovarian damage in few women during surgery). 

However, if you had previous laparoscopy and it was not possible to remove or clip the tubes, there is an alternative option, called "Aspiration"  by which the fluid inside the tube is taken out vaginally by inserting a needle under ultrasound guidance (just like egg collection) under anaesthesia. However, this is temporary measure and the fluid may accumulate later on. Therefore, it should ONLY be done in selective and difficult cases and should be done ONLY before the embryo transfer.