In order for fertilization to occur, a sperm must meet an egg. This happy event typically takes place in one of the fallopian tubes—the tube that connects the ovary to the uterus. But if one of those tubes is blocked, your chances of fertilization become much lower, which means that you will have a lower chance of getting pregnant. Hydrosalpinx is a condition where a blocked fallopian tube fills with fluid, and it is a common cause of tubal infertility. Read on to learn more about the causes, treatments, and possible pregnancy outcomes for people with hydrosalpinx.
Causes and Effects of Hydrosalpinx
The word hydrosalpinx is a combination of “hydro,” which means water, and “salpinx,” which means fallopian tube. Most of the time, hydrosalpinx is caused by a previous pelvic infection, such as those stemming from the sexually transmitted diseases chlamydia and gonorrhea. It can also be caused by scar tissue in the fallopian tubes, infection from a ruptured appendix, or endometriosis—a condition where your uterine lining grows outside the uterus and can irritate fallopian tube tissue. 
Hydrosalpinx can make it tough to get pregnant because the blockage is usually near the ovary and can make it difficult for the egg to be drawn in to the fallopian tube and to make it past the blockage to meet the sperm for fertilization. But hydrosalpinx also makes it hard to maintain a pregnancy—even one begun by in vitro fertilization (IVF)—because irritation from or leakage of fluid from the blocked fallopian tube can disturb the necessary conditions for an embryo to implant and develop in the uterus. 
Diagnosis of Hydrosalpinx
Most women do not discover that they have hydrosalpinx until they have experienced infertility because the condition only rarely causes external symptoms like pelvic pain or vaginal discharge.  If your doctor suspects hydrosalpinx, these are the common ways that he or she will diagnose it:
- In a hysterosalpingogram (HSG), the doctor fills your uterus with a type of liquid that will show up on an x-ray. He or she will then look at your reproductive system using an x-ray and trace the path the liquid takes from your uterus. If you do not have blockages in your fallopian tubes, the liquid will pass through them easily. Trapped liquid suggests that you have some kind of blockage. A less-used alternative to HSG is a sonohysterosalpingogram, where your doctor injects saline and air into your uterus and visualizes tiny air bubbles with an ultrasound. 
- Ultrasound might be effective in diagnosing hydrosalpinx, especially if it has large amounts of fluid and swelling.
- Diagnostic laparoscopic surgery is another option. In this case, your doctor usually injects your uterus with dye and then uses a tiny camera that enters your body through a small incision to assess how the dye flows through your fallopian tubes. This camera can also allow your doctor to detect hydrospalinx visually, as well as determine what else might be happening with your reproductive organs.
Treatment and Outcomes
Once you have been diagnosed with hydrosalpinx, if you would still like to become pregnant, your doctor may recommend that you have a salpingectomy, which is the removal of the affected fallopian tube. This kind of surgery can often be laparoscopic, using the same small incisions and tiny camera as in a diagnostic surgery. If you are not a candidate for laparoscopic surgery, you can also have more traditional surgery. Instead of surgery, your doctor could recommend draining the hydrosalpinx fluid, and there is some relatively recent evidence that this procedure can improve your chances of maintaining a pregnancy as well as surgery can. 
Regardless of what treatment plan your doctor proposes, he or she will also suggest IVF to help you get pregnant. With a blocked or surgically removed fallopian tube, your chances of getting pregnant on your own are quite low because one of your eggs is unlikely to meet a sperm with just one tube in which to do so. In IVF, the lack of meeting place is not a problem because doctors put the egg and sperm together in the lab and implant an embryo directly into your uterus. The good news is that once your hydrosalpinx is treated, you have an increased chance of having a healthy pregnancy after IVF. 
- American Society for Reproductive Medicine, Hydrosalpinx
- R. Gurevich, VeryWell Family, Hydrosalpinx: Treatment, Causes, Diagnosis, and Symptoms
- American Society for Reproductive Medicine, Hysterosalpingogram
- X.M. Song et al., J Obstet Gynaecol Res, 2016.
- K.E. Shelton et al., Hum Reprod, 1996.