Our Los Angeles based fertility practice, the Center for Fertility and Gynecology, is accustomed to treating patients with a wide variety of fertility issues. Some of these issues include male factor, diminished ovarian reserve, uterine factor, unexplained infertility and tubal infertility. Tubal infertility is a unique cause for infertility because it usually represents a simple obstruction that prevents sperm and egg from meeting. One specific type of tubal infertility, the hydrosalpinx, is a bit more complicated.
What is a Hydrosalpinx?
A hydrosalpinx literally means “water filled tube”. More specifically, the fallopian tube like any other mucus membrane is lined with cells which secrete fluid. The fluid is a combination of water, mucus, proteins, growth factors and hormones which aid the early embryo. That fluid normally moves freely throughout the tube and escapes into the abdominal cavity. A hydrosalpinx occurs if the end of the fallopian tube is obstructed. In such situations, the fluid continues to be produced and secreted, but it cannot escape out of the end of the tube. Consequently, the fluid accumulates within the tube itself and causes the tube to swell.
Consequences of a hydrosalpinx
In most circumstances other than fertility, a hydrosalpinx is an incidental finding which is often ignored. In fact, most women are usually completely unaware that they even have a fluid collection within their tubes. Further, hydrosalpinx are not dangerous in the traditional sense of the word. It is exceedingly rare for a hydrosalpinx to become malignant and most will shrink away when a woman becomes menopausal. Once in a while, a hydrosalpinx may cause discomfort, in such cases they can be removed through a minor surgical procedure.
In circumstances of infertility however, a hydrosalpinx has significant ramifications. The fluid collection within the tube has embryo toxic properties. This means that if the fluid leaks into the uterus it may create a non-hospitable environment for an embryo. The consequence of this is that the hydrosalpinx may prevent implantation or even cause early miscarriage.
We see evidence of this effect through comparative studies of women with and without hydrosalpinx undergoing IVF. The studies demonstrated a 50% decrease in pregnancy rate for women with hydrosalpinx. Interestingly, follow-up studies in which the hydrosalpinx was removed, demonstrated a complete return to normal pregnancy rate.
Treatment for Hydrosalpinx
Based on the studies mentioned above, the standard treatment for women with hydrosalpinx undergoing fertility treatment is laparoscopic salpingectomy. A laparoscopic salpingectomy is an outpatient surgical procedure where a camera is placed through the woman’s abdomen and then thin instruments are used to remove the swollen tube. Alternatively, some doctors prefer to simply burn the connection between the tube and uterus, this is called a tubal fulguration.
Regardless of the approach, preventing hydrosalpinx fluid from entering the uterine cavity improves pregnancy chances with IVF.
If you have questions about Fallopian tubes, IVF or any other fertility issues, please contact us. We’d be happy to speak with you.