How it is formed and why it is harmful
Normally, the final section of the fallopian tube is open into the abdominal cavity and has fimbriae that capture the egg. After inflammation, the fimbria stick together, the hole closes, and the tube continues to produce fluid, which now has no outlet.
The pipe gradually stretches, its wall becomes thinner, and the inner lining with cilia dies. Functionally, such a pipe is lost irretrievably - it is impossible to restore its transport capacity.
But the main problem is different. Fluid from the hydrosalpinx periodically flows through the uterus into its cavity. It contains inflammatory substances, mechanically washes away the embryo and worsens the condition of the endometrium. As a result, the likelihood of implantation is reduced - and this applies to both natural conception and embryo transfer during IVF.
Reasons
- Previous inflammatory diseases of the pelvic organs are the main cause
- Chlamydial and gonococcal infection
- Endometriosis with adhesions
- Surgeries on the abdominal and pelvic organs
- Appendectomy, especially complicated
- Ectopic pregnancy and tubal surgery
- Tuberculosis of the genital organs
- Abortion and complicated childbirth
- Intrauterine interventions
Symptoms
- Often there are no symptoms - hydrosalpinx is discovered during an examination for infertility
- Nagging pain in the lower abdomen on one side
- Periodic heavy watery discharge when emptying the tube
- Discomfort during sexual intercourse
- Chronic pelvic pain
- Infertility
- Repeated implantation failures during IVF
- With suppuration - pain with fever; this is already pyosalpinx, requiring urgent treatment
Diagnostics
- Ultrasound of the pelvic organs - an elongated formation next to the ovary, often with characteristic septa
- Ultrasound in dynamics - the size may change with periodic emptying of the tube
- Hysterosalpingography - obstruction of the tube with expansion of its terminal section
- Hydrosonography
- Laparoscopy is the final confirmation and at the same time the possibility of treatment
- MRI with unclear picture
- Screening for infections
- Assessment of ovarian reserve and spermogram of a partner when planning pregnancy
Treatment
- Laparoscopic tubectomy - removal of the affected tube; the most reliable option before IVF
- Laparoscopic salpingostomy - creation of a new hole while preserving the tube; considered in young women with minor lesions and plans for natural conception
- Crossing or clipping the tube at the uterine angle is an alternative to removal; it interrupts the flow of fluid into the uterus while maintaining blood supply to the ovary
- Separation of adhesions around the tubes and ovaries
- Drainage and antibacterial therapy for pyosalpinx
- IVF after elimination of hydrosalpinx
Why is this important to decide before IVF?
- Жидкость of гидросальпинкса затекает в полость матки и механически препятствует прикреплению эмбриона
- Она содержит вещества, токсичные для эмбриона
- Ухудшается восприимчивость эндометрия
- Вероятность наступления беременности при переносе эмбриона снижается существенно — примерно вдвое
- Возрастает частота выкидышей на раннем сроке
- После удаления или пересечения трубы показатели результативности возвращаются к обычным
- Именно поэтому устранение гидросальпинкса входит в стандарт подготовки к протоколу
Where is treatment in Tashkent
Good quality ultrasound, tubal patency assessment and laparoscopic surgery with gentle ovarian technique are required.
In Tashkent, examination and laparoscopic treatment of hydrosalpinx is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
If you are undergoing IVF and hydrosalpinx is described on ultrasound, be sure to discuss its elimination before entering the protocol. This is one of the few factors where simple intervention directly and significantly increases the chances. Clinic contacts are below.
