Hydrosalpinx: A Complete Guide to Causes, Symptoms, and Its Impact on Your Fertility

Receiving any diagnosis while on your fertility journey can be overwhelming. Hearing a term like "hydrosalpinx" can feel especially daunting, sending you straight to Google in a spiral of confusing medical jargon and worry.

If you're here, you're looking for clear, compassionate answers. And that's exactly what we're here to provide.

At New World Fertility, we believe that knowledge is power. Understanding your diagnosis is the first and most critical step toward finding your path forward. A hydrosalpinx diagnosis is not the end of your fertility story. It's a challenge, yes, but one with clear and effective solutions.

Let's walk through this together.

Table of Contents

• What Exactly Is a Hydrosalpinx?
• The "Why Me?" – Uncovering the Common Causes of Hydrosalpinx
• The "Silent" Struggle: Symptoms of Hydrosalpinx (Or Lack Thereof)
• The Path to Clarity: How Doctors Diagnose Hydrosalpinx
• Hydrosalpinx and Fertility: The Critical Connection
• Hope is Not Lost: Your Treatment Options for Hydrosalpinx
• Can I Get Pregnant with Hydrosalpinx?
• Your Next Steps with New World Fertility

What Exactly Is a Hydrosalpinx?

Let's break down the word. "Hydro" means water, and "salpinx" means fallopian tube.

A hydrosalpinx (plural: hydrosalpinges) is a condition where one or both fallopian tubes are blocked and fill with fluid.

Think of your fallopian tube as a delicate pathway. Normally, this tube is where the egg and sperm meet for fertilization. Tiny, hair-like projections called cilia then gently sweep the newly-formed embryo down into the uterus for implantation.

When a hydrosalpinx forms, the end of the tube (near the ovary) becomes blocked. Natural secretions and fluid, which should normally drain out, get trapped. This causes the tube to swell and distend, often resembling a small, fluid-filled sausage.

This blockage creates two major problems for fertility:

1. A Physical Barrier: Sperm can't travel up the tube to meet the egg, and a fertilized egg can't travel down to the uterus.
2. A Toxic Environment: The fluid that builds up is not just "water." It's an inflammatory fluid that is toxic to embryos.

We'll discuss this "toxic" part more in a moment, as it's the most critical factor in how we approach treatment.

The "Why Me?" – Uncovering the Common Causes of Hydrosalpinx

One of the first questions we hear is, "How did this happen?" In most cases, a hydrosalpinx is the result of a previous infection or inflammation that caused scarring.

The number one culprit is Pelvic Inflammatory Disease (PID).

PID is a serious infection of the female reproductive organs. The most common causes of PID are untreated sexually transmitted infections (STIs), particularly Chlamydia and Gonorrhoea.

Here's the chain of events:

1. An infection (like Chlamydia) goes untreated. It may have even been "silent," with no symptoms.
2. The infection travels up from the cervix into the uterus, fallopian tubes, and ovaries.
3. The body's immune system fights back, causing massive inflammation.
4. As the inflammation heals, it leaves behind scar tissue (adhesions). This scar tissue can damage the delicate lining of the tubes and seal the end of the tube shut.
5. With the end sealed, fluid builds up, and a hydrosalpinx is formed.

Other potential, though less common, causes include:

• Endometriosis: Endometrial-like tissue growing outside the uterus can cause inflammation and adhesions.
• Previous Pelvic Surgery: Scar tissue from surgeries like an appendix removal or C-section can sometimes lead to blockages.
• Past Ectopic Pregnancy: A previous pregnancy in the tube can cause significant damage.

It's important to know that in many cases, you may have done nothing "wrong." A past infection you never even knew you had could be the root cause.

The "Silent" Struggle: Symptoms of Hydrosalpinx (Or Lack Thereof)

This is one of the most frustrating parts of a hydrosalpinx: it often has no symptoms.

For the vast majority of women, the primary "symptom" is the very infertility they are seeking treatment for. They feel perfectly healthy until they start trying to conceive.

However, some women do experience symptoms, which may include:

• Chronic pelvic pain or a persistent ache in the lower abdomen.
• Unusual vaginal discharge (this is rare, but sometimes the fluid can leak out).
• Pain during or after sexual intercourse.
• Fever and pain (only during an active infection, like PID).

Because these symptoms are so vague and can be linked to many other conditions (or be non-existent), hydrosalpinx often goes undiagnosed for years.

The Path to Clarity: How Doctors Diagnose Hydrosalpinx

If your fertility specialist suspects a tubal issue, they have several excellent tools to get a clear picture.

• Hysterosalpingogram (HSG): This is the most common first-line test. A special dye is passed through your cervix into your uterus and tubes while an X-ray is taken.
• What it shows: If the tubes are open, the dye will flow through them and "spill" out into the pelvic cavity. If they are blocked, the dye will stop, and the X-ray will reveal the tube swelling with the dye.
• Transvaginal Ultrasound: A standard ultrasound may not see a normal tube. However, a fluid-filled hydrosalpinx is often visible as a distinct, black, sausage-shaped structure near the ovary.
• Saline Infusion Sonogram (SIS): This is an advanced ultrasound where sterile saline is gently infused into the uterus. It helps your doctor see the uterine cavity clearly and can also reveal a hydrosalpinx as the fluid is pushed into the tube.
• Laparoscopy: This is a minimally invasive surgical procedure and the "gold standard" for diagnosis. A small camera (a laparoscope) is inserted through a tiny incision in your belly button, allowing your doctor to directly see the fallopian tubes, ovaries, and uterus. They can confirm the diagnosis and assess the severity of the damage.

Hydrosalpinx and Fertility: The Critical Connection

This is the heart of the matter. How does this fluid-filled tube actually impact your ability to get pregnant?

As we mentioned, it's a two-fold problem.

1. Impact on Natural Conception

For natural conception, a hydrosalpinx is a complete game-stopper for that tube. The pathway is physically blocked. The sperm and egg simply cannot meet.

If you have one healthy, open tube and one hydrosalpinx, natural conception is technically possible. However, the risk of an ectopic pregnancy (a life-threatening condition where the embryo implants in the tube) is significantly higher on the affected side.

2. The Crucial Impact on IVF

Many patients assume, "If my tubes are the problem, I'll just do IVF and bypass them, right?"

This is a logical thought, but it's where hydrosalpinx presents its most serious challenge.

A hydrosalpinx can cut IVF success rates by as much as 50%.

Why? Because of that toxic fluid.

The fluid in the hydrosalpinx is not sterile water. It's an inflammatory liquid that is embryotoxic. This fluid doesn't just sit in the tube; it can and does leak or flow backward into the uterine cavity.

When a beautiful, healthy embryo is transferred into the uterus during an IVF cycle, it is landing in a "toxic bath." This fluid:

• Is directly toxic to the embryo.
• Creates an inflammatory environment in the uterine lining.
• Makes the endometrium less "receptive" to implantation.

Imagine planting a perfect seed in poisoned soil. It doesn't matter how good the seed is; it simply won't grow. This is why we must address the hydrosalpinx before starting an IVF cycle.

Hope is Not Lost: Your Treatment Options for Hydrosalpinx

Reading the above can feel heavy, but here is the good news: hydrosalpinx is a highly treatable condition. We have very effective strategies to manage it and give you the very best chance at a successful pregnancy.

Treatment almost always involves minimally invasive (laparoscopic) surgery. The goal is to stop that toxic fluid from entering your uterus.

1. Laparoscopic Salpingectomy (Tube Removal):
• This is the gold standard treatment, especially before an IVF cycle.
• The surgeon carefully removes the entire affected fallopian tube.
• Why this is the best option: It completely eliminates the source of the toxic fluid.
• Studies clearly show that women with hydrosalpinx who have a salpingectomy before their IVF transfer have pregnancy rates equal to women who never had a hydrosalpinx at all. It levels the playing field.
2. Laparoscopic Tubal Ligation (Tube Clipping):
• This is an alternative, especially if the tube is difficult to remove due to severe scarring (e.g., from endometriosis).
• The surgeon places a small clip at the very beginning of the tube, right where it attaches to the uterus.
• Why this works: It doesn't remove the hydrosalpinx, but it permanently blocks the fluid from leaking into the uterine cavity, making the uterus safe for an embryo transfer.

What about "repairing" the tube?

Sometimes, a procedure called a neo salpingostomy is discussed, which attempts to create a new opening in the blocked tube. However, for a true hydrosalpinx, this is rarely successful. The tube's inner lining and cilia are already permanently damaged, and the tube almost always scars and blocks again. For this reason, removal (salpingectomy) is strongly preferred for future IVF success.

Can I Get Pregnant with Hydrosalpinx?

Let's answer this directly:

• Naturally? It is extremely unlikely and carries a high risk of ectopic pregnancy.
• With IVF? Yes, absolutely.
• With IVF after treatment (salpingectomy or clipping)? Your chances of success are excellent.

The key is a proper diagnosis followed by the correct treatment before you attempt an embryo transfer.

Your Next Steps with New World Fertility

A hydrosalpinx diagnosis is not a dead end. It is a roadblock that we, as fertility specialists, know how to clear.

At New World Fertility, our team of reproductive endocrinologists and minimally invasive surgeons works together to create a personalized plan for you. We don't just treat test results; we treat you. We understand the emotional toll of this journey, and we are here to guide you with compassion and world-class expertise.

If you have been diagnosed with hydrosalpinx, or you suspect you may have a tubal issue, your first step is to speak with a specialist.

We will:

1. Confirm the Diagnosis: Perform a thorough evaluation, including advanced imaging, to understand your unique situation.
2. Discuss Your Options: Clearly and transparently lay out the best treatment path for you, whether that's surgery followed by IVF or another approach.
3. Support You: Our entire team, from doctors to nurses to counsellors, will be with you at every stage.

Don't let a word you'd never heard of before stop you from building the family of your dreams. There is a clear path forward.

[Click Here to Schedule a Consultation with a New World Fertility Specialist]

About the Author:

This article was written and medically reviewed by the New World Fertility Medical Team. We are a dedicated group of reproductive endocrinologists, surgeons, and scientists committed to providing compassionate, cutting-edge fertility care.