The fallopian tubes are attached to the uterus (womb) on the left and right sides. Normally, the fallopian tube picks up an egg as it is released (ovulated) from the ovary each month and this is usually where sperm and egg meet. Sperm travels from the vagina through the uterus and will eventually meet the egg join together to form an embryo (fertilized egg). The embryo travels through the tube into the uterus. When it reaches the uterus, it can start attaching to the wall of the uterus and develop into a baby.
Damage and blockage of the end portion of a fallopian tube can cause it to become filled with fluid; the swollen and fluid-filled tube is called a hydrosalpinx. A normal pregnancy in the uterus may not occur because the tube may be severely damaged, blocked and not work properly. A pregnancy may develop in the tube (ectopic pregnancy) which can be life-threatening. In addition, as the tube is blocked, secretions that collect in the tube may backflow into the uterus and prevent a pregnancy from implanting into the uterus.
Hydrosalpinx can be caused by an old infection in the fallopian tubes, sometimes a sexually transmitted infection. Other causes include previous surgery (particularly surgeries on the tube), severe adhesions of your pelvis, endometriosis, or other sources of infection such as appendicitis.
Symptoms of hydrosalpinx
Most women do not have any symptoms other than fertility problems. In some women, an ectopic pregnancy may be the first sign of a problem with their tubes. Occasionally, some women may complain of regular or constant pain in their pelvis or lower belly, which may get worse during and after their period. A vaginal discharge can also be associated with this condition.
Diagnoses of hydrosalpinx
There are three ways to check if one or both of your tubes are blocked and if you have hydrosalpinx; one or more may be performed.
Hysterosalpingogram (HSG) (x-ray)
The doctor will inject a special radiographic liquid that shows up on an x-ray into your uterus through your cervix (neck of the womb) Next, an x-ray (called a hysterosalpingogram of HSG) is taken to see where the liquid goes. If your fallopian tubes are open, the liquid will flow out of the ends of the tube into the pelvic cavity. If the tubes are blocked, the liquid will be trapped and your doctor will be able to tell that you have a hydrosalpnx. However, this test can sometimes falsely suggest that the tubes are blocked and sometimes results can be difficult to interpet.
Your doctor may be able to detect the presence of a hydrosalpinx on ultrasound. If your tube appears enlarged on ultrasound, this usually indicated a more severe hydrosalpinx.
Surgical Treatment (Laparoscopic)
Your doctor will make a small opening in your navel and insert a special scope called a laparoscope, to look at your uterus and fallopian tubes. During this surgery, the doctor will look at your fallopian tubes to see if they are blocked. Usually the doctor inserts a dye through the cervix into the uterus and fallopian tubes to confirm that the dye passes thrugh the ends of the tubes.
If your fallopian tubes are completely blocked, an egg cannot travel through them to your womb. You will need to be treated by a fertility specialist to become pregnant. Occasionally your doctor may be able to open the tubes during surgery. More often, the doctor will recommend removal of the damaged tube, since its presence if left alone, can impact adversely on overall pregnancy rates.
If there is too much damage to the tube(s), you will need treatment that does not involve the tubes to help you get regnant, such as In Vitro Fertilization (IVF).
In fact, if there is too much damage to the tube(s), you are going to need In Vitro Fertilization (IVF) to conceive. However, before the IVF, your doctor will likely recommend removal or clamping of the HYdrosalpinx because if left, the overall, IVF pregnancy rates are lower.