Hydrosalpinx
Posted on 06. Nov, 2009 by David Kreiner, MD in Causes of Infertility, Hydrosalpinx
A hydrosalpinx is a fallopian tube that is blocked at its distal end on the opposite side from the entrance to the uterine cavity. It may be diagnosed by a hysterosalpingogram or in severe cases by pelvic ultrasound. The hydrosalpinx is filled with inflammatory fluid and is most likely the end result of a pelvic infection. This inflammatory fluid can flow into the uterus and provide a hostile environment that will prevent implantation of an embryo. Research has shown that removing the hydrosalpinx (salpingectomy) or closing it off from the uterus such as with a tubal ligation significantly improves success with embryo transfer by preventing the flow of this inflammatory fluid into the uterus. Furthermore, transferred embryos will not uncommonly be pushed into the fallopian tubes after a uterine contraction. A healthy fallopian tube will sweep that embryo back into the uterine cavity with its cilia or microscopic hairs. A hydrosalpinx does not have healthy cilia so many of these embryos that find their way into the fallopian tube become trapped and may implant there resulting in a dangerous ectopic pregnancy that needs to be removed surgically if unable to destroy it medically.
A prophylactic salpingectomy or tubal ligation may be performed laparoscopically, using a tubular scope placed through the abdominal cavity to look inside the pelvis. Other instruments are placed through the lower abdominal wall and are used to remove the tube or close off the tube entrance to the uterus. Laparoscopy is performed under general anesthesia in the hospital.
Recently, the use of a contraceptive device, Essure, has been used to obstruct flow of the inflammatory fluid from the hydrosalpinx into the uterus. The Essure is a small coil that is inserted hysteroscopically through a woman’s vagina without cutting into the fallopian tube. It takes 3 months to induce adequate scar closure of the tube and is as effective as a tubal ligation. A hysterosalpingogram is performed after the 3 month period to prove adequate damming of the flow of inflammatory fluid. This procedure may be performed in an office based surgical unit and is sometimes performed without anesthesia.
D.DIRocco
Mar 5th, 2010
Hello,
My husband and I have tried to get pregnant on our own for a year with no luck. We recently started a workup with my GYN. He had a sperm anaysis done and we found out he has an infection and his urologist put him on Cipro. for one month. The volume was a little low, but everything else looks fine. This week I had an attempted Endo. Biopsy and with two tries it was unsucessful. I am scheduled to have a synohystergram. I walked out of the docter feeling the worst ever, nothing explained other than we do not know what it is for sure, but there is a blockage and the syno. needs to be done. At this point I’m in panic mode and I won’t know much until the test is done. At this point ,i’m not sure if it is time to see a fertility specialist. If possible could I get your professional guidance. Thank you.
Kreinerivf
Mar 6th, 2010
You may get varying opinions as to when to seek help from a reproductive endocrinologist. The ASRM recommends after 6 months of unprotected intercourse if you are 35 or older and after 1 yr if you are under 35. Other variables include your motivation level, your confidence in your ob gyn as well as any problems that are known that may suggest closer attention. In particular if you had irregular cycles, a history of abdominal or pelvic or cervical surgery or family h/o premature menopause or diminished ovarian activity, or h/o endometriosis.
Mark
May 27th, 2011
My wife has severe endometriosis and she had the right ovary and tube removed. She was also diagnosed with hydrosalpinx in the remaining tube which according to her IVF doctor was the cause for the failure of the two ivf cycles we tried so far.
Now he recommended that she go for a Essure procedure since more invasive procedure is not an optional (lots of adhesions) I pretty much understood the mechanics of this medical procedure; however, my question lies on what happen to the fluid inside the tube once the tube is blocked by the Essure? If the fluid inside is caused by an inflammatory process in the tube, I assume that even after blocking the tube the fluid will continue to be created. Therefore, what happens to the fluid inside and where does it go if there is no more chance to overflow into the uterus? Would the Essure cause the tube to expand because of the liquid inside?
Thank you
Mark