Hydrosalpinx: Symptoms, fertility, and treatment
There are different causes for this condition and symptoms can vary depending on the individual. Some women do not experience any symptoms, but hydrosalpinx can have a severe impact on fertility.
Symptoms of hydrosalpinx include:
- abdominal and pelvic pain
- unusual vaginal discharge
However, it is possible to have hydrosalpinx and not experience any symptoms.
Because hydrosalpinx impacts infertility, many women only discover they have the condition when trying to get pregnant.
Hydrosalpinx is characterized by one or both fallopian tubes being filled with water.
Image credit: BruceBlaus, (2016, January 25)
A doctor can diagnose hydrosalpinx using several methods. These include:
- A sonohysterosalpingography: This is when saline fluid and sterile air are passed through a woman's cervix and into the uterus. A transvaginal ultrasound is then used to look at the reproductive organs to see if a blockage is present.
- An ultrasound: This is one way of looking for hydrosalpinx, but is not as effective. One study reported that only 34 percent of cases were visible using ultrasound.
- Hysterosalpingogram (HSG): This is a type of X-ray that can display tubal blockages. A special dye visible to the X-ray is introduced through the vagina and cervix.
- Laparoscopy: Also known as keyhole surgery, a laparoscopy is a surgical procedure where small incisions are made in the abdomen, and a camera is inserted. This allows a surgeon to see the organs and remove fluid or other issues.
A diagnostic laparoscopy can also determine whether there is another issue that may be causing infertility, such as endometriosis.
Causes and risk factors
There are several different reasons why hydrosalpinx may occur. The most common causes include:
- sexually transmitted infections (STIs)
- pelvic inflammatory disease (PID)
- ruptured appendicitis
- abdominal surgery
When an area of the body suffers an injury, the body quickly transports inflammatory cells into the area as part of an immune response.
In a fallopian tube, the inflammation and healing can cause loss of the fimbria (finger-like projections at the end of the fallopian tube) and the eventual closure of the tube.
Hydrosalpinx and infertility
Anyone with hydrosalpinx should seek professional advice for planning a pregnancy.
During conception, the egg travels from an ovary along the fallopian tube to the uterus. Hydrosalpinx causes the fallopian tube to become blocked with fluid, so the egg cannot pass down the tube,
Also, the fimbria that help to draw the egg from the ovary into the tubes can become stuck together.
If only one fallopian tube is blocked, it is still possible to conceive without intervention, as eggs from the other ovary will still be able to make it to the uterus.
There is also a chance that the fluid buildup could leak into the uterus and interfere with the embryo implanting itself properly.
Treatment and management
The most common treatment for a woman with hydrosalpinx is to have surgery to remove the affected tube. This type of surgery is known as salpingectomy.
Surgery may also be offered to remove scar tissue or other adhesions that could be affecting fertility.
If endometriosis is found to be the cause, doctors can also remove the endometrial growths.
In instances where PID is the cause, a doctor may prescribe a course of antibiotics to treat any remaining infections.
Many women who have hydrosalpinx choose to use in vitro fertilization (IVF) treatment when trying to conceive.
If IVF treatment is started before surgery to remove the affected tube, chances of success are lower. It is, therefore, recommended to complete surgery before undergoing IVF treatment to ensure the best chances of success.
Another possible treatment is sclerotherapy. Sclerotherapy is where an ultrasound-guided needle is used to draw fluid out of the affected tube. A special chemical, called a sclerosing agent, is then injected, which should prevent the fluid from building back up again.
Minimal research on sclerotherapy has been carried out, so it is difficult to determine the associated risks and whether its effectiveness can match that of removing the tube in its entirety.
IVF may help those with hydrosalpinx to conceive.
It is possible for a woman to get pregnant with hydrosalpinx. However, chances of a successful pregnancy depend on the cause and severity of the blockage, and whether the woman has undergone any treatment.
Conception may occur without any treatment, but chances are lower and the risks of complications, such as early pregnancy loss, are more significant.
If a woman decides to have treatment for hydrosalpinx, chances of a successful pregnancy are higher, particularly if IVF treatment is given after treatment has taken place.
It is thought that both salpingectomy and sclerotherapy have similar success rates when combined with IVF treatment, but more research needs to be done to confirm this.
A doctor will be able to talk through the different treatment options and help a woman decide what option is best for her.