It is possible to achieve pregnancy with a hydrosalpinx in only one fallopian tube, but the condition introduces unique challenges to both natural conception and assisted reproductive methods. Hydrosalpinx is a specific form of tubal factor infertility where a fallopian tube becomes blocked and distended with fluid. This blockage is typically caused by a prior infection, endometriosis, or past surgery. Understanding this blockage is the first step in determining the path toward a successful pregnancy.
What Hydrosalpinx Means for Fertility
Hydrosalpinx occurs when the end of the fallopian tube near the ovary becomes sealed, causing secretions from the tube’s inner lining to accumulate and swell the tube. This physical blockage prevents the egg and sperm from meeting, which is the site of natural fertilization. The damaged tube is functionally non-existent for the purpose of conception.
Beyond the mechanical obstruction, the fluid inside the hydrosalpinx negatively affects the uterine environment. This fluid can leak backward into the uterus, potentially compromising the lining and interfering with embryo implantation. This toxic effect can reduce the success rates of both natural pregnancy and fertility treatments. The presence of this inflammatory fluid can impair the uterine lining’s receptivity, even for a healthy embryo.
Probability of Natural Conception
Natural conception remains a possibility when only one fallopian tube is affected, provided the other tube and ovary are healthy and fully functional. The healthy tube can successfully capture the egg released from its adjacent ovary, allowing fertilization and transport to the uterus. In women with unilateral hydrosalpinx, the overall probability of natural pregnancy is reduced because the reproductive capacity is essentially halved.
The healthy fallopian tube can sometimes compensate for the blocked side through a phenomenon known as transperitoneal migration or “pickup.” This process involves the healthy tube reaching across the pelvis to capture an egg released by the ovary on the side with the hydrosalpinx. While this mechanism increases the chances of conception, success is reliant on the health of the remaining tube and the overall quality of the egg.
The chronic inflammation caused by the hydrosalpinx can still decrease the cycle fecundity compared to women with two healthy tubes. The leaking fluid may impair the overall environment of the pelvis and uterus, reducing the natural conception rate. This is why addressing the damaged tube is often recommended, even for those hoping to conceive naturally.
Addressing Risks to Fetal Health
The presence of a hydrosalpinx introduces specific risks during the conception and early pregnancy phases. One significant concern is the increased risk of an ectopic pregnancy, where a fertilized egg attempts to implant within the damaged, non-functional tube. An ectopic pregnancy is a medical emergency that cannot continue and poses a serious threat to maternal health.
If a healthy embryo manages to travel to the uterus, the toxic fluid that refluxes from the hydrosalpinx can still compromise its chance of survival. This fluid is believed to contain compounds that are directly harmful to the embryo or that alter the uterine lining, making implantation difficult. Studies have shown that the presence of hydrosalpinx is associated with a significantly higher risk for miscarriage. The mechanical action of the fluid flushing the embryo out of the uterus is another proposed mechanism for implantation failure and early pregnancy loss.
Assisted Reproductive Options
When natural conception does not occur or the risks associated with the hydrosalpinx are deemed too high, medical interventions are available. The primary assisted reproductive technology used in these cases is In Vitro Fertilization (IVF), which completely bypasses the function of the fallopian tubes. IVF involves fertilizing the egg outside the body and transferring the resulting embryo directly into the uterus.
Before proceeding with IVF, a procedure called salpingectomy, which is the surgical removal of the affected tube, is often recommended. Removing the source of the toxic fluid eliminates the negative impact on the uterine environment, which is known to significantly improve IVF success rates. Research indicates that removing the hydrosalpinx can nearly double the embryo implantation and pregnancy rates during IVF. Alternatively, a less invasive procedure to block the tube near the uterus can be performed to prevent the fluid from draining into the uterine cavity.