- Fertility Treatment Options
- Ovulation Induction
- Intra Uterine Insemination (IUI)
- In Vitro Fertilization (IVF) ± ICSI
- Male Infertility Treatment
- Reproductive Surgery
- Embryo Transfer
- Blastocyst Transfer
- Assisted Hatching
- Assisted Hatching
- Embryo Freezing
- Fertility Preservation
- PGD/Genetic Diagnosis of Embryos
What is a Hydrosalpinx?
- Hydrosalpinx, derived from Greek, is a word literally meaning, "water tube". A Hydrosalpinx is a blocked, dilated, fluid filled-fallopian tube usually caused by a previous tubal infection
- Hydrosalpinx is a classic fertility problem that prevents embryos from reaching the uterus and limits pregnancy rates. It can interfere with fertility therapy and cause problems for in vitro fertilization
- Not only does a hydrosalpinx cause infertility, it can also reduce the success rate of fertility treatment, even those treatments that bypass the fallopian tubes (IVF)
- The blocked tube can communicate with the uterus, and the fluid in the tube can be expressed out of the tube into the uterus
- This fluid is probably somewhat toxic to early embryo development, and certainly provides an unfavorable environment
- The large volume of the fluid flows back into the uterus and can produce enough flow that embryos find it difficult to attach, since they have no ability to move against the tide
- Hydrosalpinx can be evaluated with several maneuvers:
- The Hysterosalpingogram (HSG) is a procedure in which dye is placed through the cervix and into the uterus and fallopian tubes. An X-ray picture then reveals the outline of the uterus and tubes. A hydrosalpinx appears as a large-sausage-shaped dilation of the tubes. The folds that are present inside the tube disappear and a flat bulbous shape is seen. Dye does not spill out of the tube.
- Ultrasound uses sound waves to image the tubes, and is somewhat safer than HSG and more comfortable. The best view, most of the time, is obtained with a vaginal ultrasound probe. A normal fallopian tube is usually not visible; a hydrosalpinx appears as a characteristic sausage-shaped fluid collection between the ovary and fallopian tube. The wall of the hydrosalpinx is often thick and flat. Ultrasound provides a quick and painless screen of the pelvic organs and is an excellent first assessment of the tubes.
- Diagnostic tests such as ultrasound and HSG are not 100% accurate, and can be misleading, sometimes missing significant tubal disease, and sometimes showing abnormal results when the tubes are actually quite normal. Laparoscopy usually will confirm the diagnostic tests, but can show that tubes that were thought to be normal actually have significant disease, and vice versa. The risks of anesthesia and surgery dictate that laparoscopy is used for definitive therapy, rather than as a diagnostic test.
- Treatment:In vitro fertilization is the ultimate fertility therapy. The hydrosalpinx (damaged tube) should be removed; this procedure is called salpingectomy and is performed through laparoscope. In patients with hydrosalpinx, the fallopian tubes can be bypassed, since eggs are taken out of the ovary, fertilized in the lab, and transferred back into the uterus.