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Hydrosalpinx And Infertility

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A hydrosalpinx is a blocked fallopian tube filled. With serous or clear fluid the blocked tube may have sausage like appearance.

Fallopian tube when filled with blood is called hematosalpinx as commonly seen in tubal pregnancy cases. Fallopian tube is filled with pus is called pyosalpinx seen in PID and tubo ovarian abscess.

ANATOMICAL STRUCTURE

Tubes have 4 parts (lateral to medial)

Fimbriae: which capture the ovum from the surface of the ovary.

Infundibulum: Opening to which fimbriae are attached.

Ampulla: Site of Fertilization.

Isthmus: This connects the ampulla to the uterine cavity.

The main function of Fallopian tubes is not only transfer of egg and embryo to the uterine cavity but tube also provides nutrition to early growing embryo for 5 days. It is the site of fertilization and also growth of embryos up till blastocyst stage.

WHAT CAUSES A HYDROSALPINX?

  • Sexually Transmitted Disease(STD’s)
  • Ruptured Appendix
  • Tubal Surgeries
  • Intra Uterine Devices ( IUD’s)
  • Genital Tuberculosis
  • Endometriosis

WHAT ARE THE SYMPTOMS OF HYDROSALPINX?

Many a times Hydrosalpinx is asymptomatic meaning these are diagnosed incidentally. Some patient may have symptoms like:

  • Dull ache in lower abdomen which is some times prononced.
  • Inability to conceive.
  • Excessive vaginal discharge.

How is a Hydrosalpinx Diagnosed?

HSG : HSG is an X-ray that is used to examine the cavity of the uterus and fallopian tube.

Sonohysterosalpingography: An ultrasound contrast saline (10-14 ml) is injected into the uterus through the cervix by the foley’s catheter and the passage of saline is followed by TVS.

Diagnostic laparoscopy: It is a surgical procedure that is used to view a women reproductive organs. For this a laparoscope is passed through small incision in the abdominal wall.

Does Hydrosalpinx Cause Infertility

Yes, the main symptom of a hydrosalpinx is infertility. Normal, patient, functioning fallopian tubes are must for egg and sperm interaction, fertilization and subsequent embryo development.

Hydrosalpinx decreases the Success of IVF

Hydrosalpinx definitely decreases the success rate of IVF to less than 10%. So IVF should not be done in the presence of communicating hydrosalpinx and it is advised that tubal opening into the uterus should be blocked by laparoscopic tubal clipping or delinking the tubes.

There are various assumptions that try and explain why the conception rates are lower in Hydrosalpinx.
  • One assumption is, that the flow of fluid (present in fallopian tube) into the uterus hinder the implantation rate of an embryo. As this fluid contains some amount of debris, and other toxic substances that are harmful to the embryo.
  • Another assumption is, that the fluid acts as a mechanical flush that can swipe away the embryo.
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