What Is Hydrosalpinx, and How Does It Affect Fertility?

Experiencing infertility and going through assisted reproductive technology (ART) to conceive is challenging enough. Add a health issue that could impact your chances of a successful pregnancy, and it’s downright stressful!

Hydrosalpinx is one such condition affecting your fallopian tubes — and it’s one of those things you probably don’t worry about (or even know what it means!) until you have it.

Hydrosalpinx is a block fallopian tube

Hydrosalpinx refers to a blocked fallopian tube that can increase the risk of pregnancy loss.

“A hydrosalpinx is a blockage typically at the end of the fallopian tube, which then causes fluid build-up and dilation of that tube, damaging fertility,” said Jessica Ann Ryniec, MD, double-board certified reproductive endocrinologist and infertility specialist.

Signs and symptoms

It can be tricky to diagnose hydrosalpinx, as the majority of women with hydrosalpinx will have no signs or symptoms. However, the condition can also cause pelvic or abdominal pain; tubal factor infertility; and/or abnormal vaginal discharge.

To diagnose a hydrosalpinx, your doctor might order a transvaginal ultrasound or a hysterosalpingogram (HSG), “which is a test where dye is put into the uterus and X-ray images are taken to look at the uterine cavity and fallopian tubes,” explained Dr. Ryniec.

How hydrosalpinx affects your fertility

Approximately 25% of infertility cases are associated with tubal issues, with the most severe being hydrosalpinx, which accounts for 10-30% of tubal diseases.

Studies have shown that women undergoing in-vitro fertilization (IVF) or embryo transfer (ET) had lower rates of pregnancy and implantation with hydrosalpinx compared to women with other tubal diseases, partly because the hydrosalpingeal fluid is toxic to developing embryos. Not to mention, the presence of excessive fluid in the uterine cavity may hinder implantation.

“A hydrosalpinx can impact fertility in a number of ways,” Dr. Ryniec explained. These include “preventing sperm from meeting egg due to the blockage, implantation issues either due to toxicity of hydrosalpinx fluid or the fluid flushing the embryo out, and increased risk of ectopic pregnancy due to the dilation, which makes the tube function abnormally.”

Additionally, hydrosalpinx can increase the instances of pregnancy loss, with research showing a 74% relative increase in the risk of pregnancy loss in women with hydrosalpinx compared to women without.

Other studies have found that hydrosalpinx is associated with a decreased pregnancy rate and implantation, and an increased rate of ectopic pregnancy and miscarriage. Meanwhile, treatment with salpingectomy, tubal occlusion, or hydrosalpinx aspiration led to better IVF pregnancy rates.

What are my treatment options for hydrosalpinx?

If you discover the presence of hydrosalpinx while you’re trying to conceive, there are treatments available that can increase your chances of getting pregnant.

“If trying to conceive, most often the treatment is surgical removal of the fallopian tube or alternatively, clipping off the fallopian tube so that it does not communicate with the uterus,” Dr. Ryniec said, referring to a treatment called a salpingectomy.

“It may also be possible to surgically create an opening in the fallopian tube,” Dr. Ryniec continued, referring to a salpingostomy or distal tubal plastic surgery. This does come with some risk, though. “Oftentimes the damage remains and there is a much higher risk of ectopic pregnancy,” Dr. Ryniec explained.

In cases of distorted pelvic anatomy or pelvic adhesions that would make abdominal surgery riskier, your medical provider might opt for a proximal tubal occlusion with Essure devices.

Alternatively, a 2017 study found that a sclerotherapy (aspirating the tube transvaginally, then injecting it with liquid) before IVF can be used an alternative to salpingectomy to increase fertility outcomes.

Is hydrosalpinx preventable? Maybe…

The most common cause of hydrosalpinx is pelvic inflammatory disease (PID); however, the condition can affect anyone with fallopian tubes, including, in rare cases, prepubescent girls who haven’t started their period yet. “The main way to prevent one of the most common causes of a hydrosalpinx (which is pelvic inflammatory disease) is to protect against sexually transmitted infections like gonorrhea and chlamydia,” Dr. Ryniec explained. She said using condoms during sex, and making sure you and your partners are regularly tested, can help lower your risk of developing an STI, which can cause PID.

What’s the cause of hydrosalpinx?

Hydrosalpinx can happen for many different reasons, all of which boil down to something blocking the fallopian tube. Here are some of the most common culprits behind that blockage — and how each one can lead to a buildup of fluid.

• Sexually transmitted infections (STIs) can inflame the tubes, causing scarring that blocks the normal flow of fluid.
• Endometriosis sometimes creates scar tissue or lesions on the fallopian tubes, leading to fluid buildup.
• Previous fallopian tube surgery can leave behind scar tissue or alter the tube’s shape, setting the stage for hydrosalpinx.
• A fallopian tube infection inflames and can eventually block the tube, trapping fluid inside.
• A fallopian tube tumor may physically obstruct the tube, preventing fluid from draining as it should.
• Tubal pregnancy that leads to distal tubal occlusion can cause damage or swelling in the tube — especially near the outer end — leading to fluid buildup.

“Unfortunately, there is not necessarily a way to prevent a hydrosalpinx due to other causes, like endometriosis, except for having prompt evaluation of any pelvic pain concerns,” Dr. Ryniec added.

If you have hydrosalpinx, it can be frustrating to have one more thing (literally) blocking your ability to conceive or carry a pregnancy. But with many safe and effective treatments available, a diagnosis of hydrosalpinx doesn’t have to mean an end to your reproductive plans. It’s just one more, easily fixable bump in the road to parenthood.

Sydni Ellis is a freelance writer whose work has appeared in HuffPost, SheKnows, Motherly, Romper, POPSUGAR, and other publications focused on lifestyle, entertainment, parenting, and wellness. She has a Master of Journalism from the University of North Texas and a Best Mama award from her three little boys (at least, that’s what she thinks the scribbled words on the card say). When she isn’t busy singing along to Disney movies and catching her husband up on the latest celebrity gossip, she can almost always be found with a good book and an iced coffee in hand.