Hydrosalpinx is a condition where a fallopian tube becomes blocked and fills with fluid, significantly impacting fertility. Many individuals wonder if conception is still possible when only one fallopian tube is affected.
What is Hydrosalpinx?
Hydrosalpinx occurs when a fallopian tube becomes blocked, typically at its fimbriated end near the ovary, and fills with fluid. This blockage prevents the normal passage of an egg from the ovary to the uterus and can also impede sperm from reaching the egg. The accumulation of fluid causes the tube to swell and distend.
This condition often develops as a consequence of past pelvic infections, such as pelvic inflammatory disease (PID), which can be caused by sexually transmitted infections. Endometriosis, a condition where uterine-like tissue grows outside the uterus, or prior abdominal or pelvic surgeries can also lead to hydrosalpinx. Diagnosis frequently involves imaging techniques like a hysterosalpingogram (HSG), which uses dye to visualize the fallopian tubes, or a transvaginal ultrasound, which can sometimes identify the fluid-filled tube. Laparoscopy, a surgical procedure, offers a definitive diagnosis and can provide a clearer view of the affected tube.
Fertility with One Affected Tube
Achieving pregnancy is possible when one fallopian tube is healthy and functional, even if the other tube is affected by hydrosalpinx. The healthy tube can still ovulate, capture the egg, and allow for fertilization and transport of the embryo to the uterus. The healthy ovary on the side opposite the affected tube can release an egg that is then picked up by the functional fallopian tube.
Despite a healthy tube, a hydrosalpinx in the other tube can still negatively influence fertility. The fluid within the diseased tube often contains inflammatory and toxic substances that can leak into the uterus. This creates an environment detrimental to embryo implantation, impairing embryo viability and potentially washing away embryos or disrupting implantation. While one healthy tube offers a pathway for conception, the adverse effects of the hydrosalpinx on the uterine environment can still pose a significant barrier to pregnancy.
Treatment Options for Conception
Several medical approaches can help individuals trying to conceive when one fallopian tube has hydrosalpinx. Surgical removal of the affected fallopian tube, salpingectomy, is often recommended. This procedure eliminates the source of the toxic fluid, improving the uterine environment for embryo implantation and increasing fertility treatment success. Salpingectomy is generally preferred over repair, as repaired tubes often remain dysfunctional and pose risks.
Another surgical option, salpingostomy, involves creating an opening in the blocked tube to drain the fluid and restore patency. However, salpingostomy has a lower success rate for live births compared to salpingectomy, as the tube often re-blocks or remains impaired. Due to high re-blockage and ectopic pregnancy risks, salpingostomy is not typically recommended for improving fertility outcomes.
In Vitro Fertilization (IVF) is frequently utilized. IVF bypasses the fallopian tubes entirely by fertilizing eggs with sperm. Embryos are then transferred into the uterus. When hydrosalpinx is present, especially if the affected tube is not removed, IVF success can be reduced due to the fluid’s negative impact on embryo implantation. Therefore, salpingectomy is often advised prior to IVF to maximize pregnancy chances.
Potential Pregnancy Complications
Even after achieving pregnancy with hydrosalpinx in one tube, certain risks can be elevated. A primary concern is an increased risk of ectopic pregnancy, where the fertilized egg implants outside the uterus, most commonly in a fallopian tube. While the affected tube is the most common site for an ectopic pregnancy, even the seemingly healthy tube can have subtle functional impairments that increase this risk. The hydrosalpinx can also affect embryo transport, potentially drawing an embryo into the diseased tube or impacting the healthy tube’s ability to properly transport an embryo.
The toxic fluid from the hydrosalpinx can also contribute to a higher risk of miscarriage. As this fluid leaks into the uterus, it creates an inflammatory environment hostile to the developing embryo, potentially leading to implantation failure or early pregnancy loss.