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Hydrosalpinx

A hydrosalpinx is a damaged fallopian tube that is filled with fluid. When a previous infection injures a fallopian tube, it often causes the end of the tube to close. Glands produce a clear, watery fluid inside the tube that would normally be secreted and then reabsorbed; however, damaged tubes cannot reabsorb this fluid, so it builds up. Once the fallopian tubes are completely blocked, pregnancy is nearly impossible.

Causes

A hydrosalpinx is usually caused by a pelvic infection or inflammatory disease that spread through the cervix and uterus to the fallopian tubes. These types of diseases, such as gonorrhea and chlamydia, can cause sever symptoms, mild symptoms or no symptoms at all, and if left untreated, they can cause significant damage to the reproductive organs. Scar tissue, IUDs, endometriosis, childbirth and abortions can also cause a hydrosalpinx.

A hydrosalpinx can be one-sided, but infections usually affect both tubes and cause significant damage. For women with a hydrosalpinx on both sides, the only possible way for them to conceive "naturally" is through surgery.

Complications

Infertility is not the only result of a hydrosalpinx. It can also decrease a woman's chances of undergoing successful cycles of fertility treatment, even those that don't require use of the fallopian tubes. Fertility drug therapy may worsen the condition by causing even more fluid build-up in the fallopian tubes, since they are responsive to the hormones produced by these kinds of medications. This built-up fluid can be expressed out of the tubes and into the uterus, which may be toxic to a developing embryo or make it difficult for implantation to occur. Researchers are still conducting studies to determine the effects of tubal fluid spilling back into the uterus. One study found that the risk of miscarriage is doubled in women with a hydrosalpinx.

A hydrosalpinx can also be hazardous during fertility evaluation and treatment because it is vulnerable to re-infection. Some treatments, such as insemination and embryo transfer, may inadvertently introduce bacteria into the tubes and result in a serious infection. Salpingitis, the medical term for an infection in a hydrosalpinx, may require emergency surgery and hospitalization. Diagnosis

Below are several ways a doctor can evaluate and diagnose a hydrosalpinx.

  • Ultrasound - An ultrasound is typically quick and painless. A vaginal ultrasound probe uses sound waves to project an image of the fallopian tubes on a screen. While a normal fallopian tube is not visible, a hydrosalpinx appears as a sausage-shaped collection of fluid between the ovary and the fallopian.


  • Hysterosalpingogram (HSG) - HSG is a procedure in which a special dye is inserted through the cervix and into the uterus and fallopian tubes which the doctor is then able to view on an x-ray. An outline of a hydrosalpinx in an HSG image resembles a large sausage. Both HSG and an ultrasound can be misleading in detecting a hydrosalpinx, sometimes missing significant tubal disease and sometimes showing abnormal results when the fallopian tubes are normal.


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