By Dr. Álvaro Díez Álvarez (Gynecologist – License No. 282865580).
The term ‘hydrosalpinx’ is formed by combining two Greek words: ‘hydro’ (water) and ‘salpinx‘, meaning tube. This clarifies that hydrosalpinx is a condition of the fallopian tubes involving a fluid accumulation. Throughout this article, we will explore why this condition may adversely affect the achievement of pregnancy and what treatment options exist nowadays in order to face it.
The fallopian tubes are the ducts that connect the ovaries to the uterus. Understanding the implications of fallopian tube-related pathologies requires knowing their function and acknowledging the essential role they play in the process of having a baby.
Their main functions are:
When the fallopian tubes are blocked or damaged, these tasks can be compromised. This makes fertilization and implantation difficult or impossible.
Hydrosalpinx presents as an abnormal accumulation of fluid in the fallopian tubes. This causes them to dilate. Hydrosalpinx can be unilateral or bilateral, depending on whether it affects one or both tubes.
Although some patients are asymptomatic, the clinical manifestations women describe include:
The main causes of its appearance are infections the patient has experienced or abdominal adhesions that may occur. For example, it can occur in women with endometriosis. Additionally, other factors, such as having experienced an ectopic pregnancy, also trigger the development of adhesions, just as some surgeries or traumas can lead to hydrosalpinx. In summary, it is crucial to understand that the fallopian tubes dilate because they become obstructed, ceasing to fulfil the important function of generating the conductive flow destined for the uterus.
While many patients may be asymptomatic, chronic pelvic pain, menstrual imbalances or dyspareunia (pain during sexual intercourse) are among the clinical manifestations described by women with hydrosalpinx. However, in either cases the problem is not always easy to identify during routine gynaecological check-ups, and symptoms may be mild or attributed to other conditions, which makes them unrelated to the hydrosalpinx unless specialised care is sought -as is the case when requesting reproductive counselling.
Identifying conditions such as hydrosalpinx is essential for reproductive medicine professionals to choose the most suitable approach and treatment for each woman. When there is suspicion that tubal pathology may be hindering pregnancy achievement, various techniques can be employed to confirm this hypothesis and provide more information about it.
In general terms, transvaginal ultrasound scan is the primary method for diagnosing hydrosalpinx, as dilated fallopian tubes are clearly visualised. Similarly, magnetic resonance imaging (MRI) is extremely useful for confirming the existence of the pathology.
On the other hand, laparoscopy is a more traditional diagnostic technique that provides a direct image of the tubes using an endoscope. In order to introduce this instrument into the woman’s body, a small incision is made in her abdomen, which requires the use of anaesthesia. This makes this method a more invasive process than the other alternatives, and therefore, it is not commonly used to diagnose hydrosalpinx, but to perform salpingectomies (removal of one or both fallopian tubes).
Another test that some professionals recommend in these cases is hysterosalpingography (HSG). Thanks to this procedure, doctors visualise the fallopian tubes and uterine cavity using X-rays, which is made possible by administering an iodinated contrast that allows the patency of the tubes to be studied. HSG is also useful for detecting uterine anomalies, adhesions, or scars that may hinder embryo implantation or cause miscarriages.
However, despite the prevalence of all these techniques, it is worth mentioning the innovative one, which is hysterosonography. This, performed in-house at our centres, is a procedure similar to HSG, with the advantage of replacing radiation with ultrasound. This is harmless to the patient and allows visualising the fallopian tubes by applying a contrast in the cavity.
At IVF-Life, we consistently convey our commitment to scientific development and excellence in reproductive medicine for a reason. An experienced and expert team specialised in reproductive medicine is crucial for the intricate puzzle of creating life.
Success stories from our patients with hydrosalpinx becoming mothers through treatments offered by our professionals serve as evidence that you can also achieve your goal.
The approach to cases of hydrosalpinx will be based on its significance, with surgery often chosen, when the hydrosalpinx communicates with the uterus. Surgery tends to be performed as a preventive measure for a potential pregnancy since the fluid that has been mentioned, accumulating in the fallopian tubes, can be toxic to the embryo and impact endometrial receptivity.
Specialists at IVF-Life will choose the most appropriate treatment, with In Vitro Fertilisation being a common option. IVF involves fertilising an egg with sperm (from a male partner or a donor) in our laboratories.
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