Hydrosalpinx
9 Replies
Praying4baby - July 27

I was recently diagnosed with a hydrosalpinx in my right tube, constituting appriximately 40% of the distal end. The HSG showed that the left tube was open. Statistically speaking, what are my chances of conceiving naturally? Should I look into having the hydrosalpinx removed? My doctor feels that we should wait 6-9 months since there are no other known fertility factors. Any advice that you could offer would be greatly appreciated.

 

B. Jacobs, M. D. - July 27

If you have a hydrosalpinx on one side, you probably have damage on the other side, which is "open". Damaged tubes increase the risk of tubal pregnancy. Also, we know from IVF that hydrosalpinx interferes with embryo implantation.
Good luck.

 

Praying4baby - July 28

Dr. Jacobs,

Thank you for the information. Does that mean that the majority of women who are diagnosed with a unilateral hydrosalpinx can almost never conceive naturally?

Thank you.

 

B. Jacobs, M. D. - July 28

I have no data to determine the probability of a successful pregnancy with only a single hydrosalpinx, and a patent tube on the other side. There is a greater potential for a tubal pregnancy in the case described.

 

Praying4baby - August 4

Dr. Jacobs,

If the fluid from a hydrosalpinx drains into the uterus, will there be a noticable discharge after ovulation? I assume that the fluid drains around the same time that the isthmus relaxes to allow the embryo to pass into the uterus.

Thank you for your help.

 

B. Jacobs, M. D. - August 4

If you have a hydrosalpinx, you are not likely to conceive without IVF. If you do, you will probably have a tubal pregnancy. With IVF, you totally bypass the tubes, and the embros are never in the isthmus portion of the tubes. If the fluid drained, there would be no fluid in the tubes.

 

kazata - August 10

My research shows that removal of a unilateral hydrosalpinx improves the chances of natural pregnancy. See for example, this article:

http://humrep.oxfordjournal
s.org/cgi/content/full/18/12/2634

(I
had a recent lap which confirmed a right hydrosalpinx, but the left tube was fine. In my case it was due to a congenital defect - the fimbria portion of the right tube, though normal (not closed), was not connected to the remaining portion, but the remainder was closed at the top and constantly filling with fluid).

Alternatively, even if pursuing IVF, it is my understanding that the hydro should be removed, b/c it impairs chances of conception, even though IVF bypasses the tubes.

 

B. Jacobs, M. D. - August 10

You are correct.

 

kazata - August 10

I meant to ask why you believe that the "open" tube would also be damaged (is it due to the fluid from the other tube, or simply b/c the usual reason for a hydro is infection?) Is there some way to detect whether there is damage to the other tube? Would it also need to be removed prior to IVF? In the article I cited above, none of the patients had ectopic pregnancies after removal of a unilateral hydrosalpinx.

 

B. Jacobs, M. D. - August 11

It is extrenmely rare to have a hydrosalpinx, without having had an infection in your fallopian tubes. Infection effects both tubes, but damage may be worse in one than the other. For IVF the issue is the fluid trapped in the tube which is a hydrosalpinx.

 

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