Treatment before IVF: In many cases, it’s recommended to surgically correct or remove the affected fallopian tubes (salpingectomy) before undergoing IVF. Removing the hydrosalpinx can improve the chances of success by eliminating the adverse effects it can have on embryo implantation and pregnancy rates.

Salpingectomy vs. tubal occlusion: While salpingectomy (removal of the fallopian tubes) is often recommended to improve IVF outcomes in cases of hydrosalpinx, some studies suggest that simply occluding or blocking the tubes (tubal occlusion) may also be effective. However, the choice between these approaches depends on various factors, including the severity of hydrosalpinx, patient preferences, and the advice of fertility specialists.

Treatment Options for Hydrosalpinx:

The treatment options for hydrosalpinx depend on several factors, including the severity, the desire for future children, and other individual considerations. Some treatment options include:

Medical treatment: There is not much role for medical treatment in an already existing hydrosalpinx. In women with active infection of the hydrosalpinx with pain or fever responds well with antibiotic treatment for symptom relief but the effect on function and tubal quality is questionable.

Laparoscopic surgery:  

 Salphingolysis/Fimbriolysis/ Tubal cannulation: This minimally invasive surgery aims to open the blockage of the fallopian if possible, to restore fertility. Opening of tube is possible depending on various factors like the severity of adhesions, amount of tubal distension with fluid. Tubal function can be tried to be restored if there is minimal adhesion especially at the fimbrial end mostly seen with cases of endometriosis and mild pelvic infection. In some cases even if the fallopian tube is open after surgery there is a risk of having ectopic pregnancy (pregnancy inside the fallopian tube) due to the damage already caused to the tube by the fluid collection.

Salpingectomy: If the fallopian tube is grossly distended with fluid or damaged with scarring or endometriosis then the only option is removing the entire affected fallopian tube called salpingectomy. This option is often considered if the tube is severely damaged or if pregnancy is not desired. Those who desire to have pregnancy the only option is to go for IVF, in case of removal of both the tubes.

Hydrosalpinx Surgery: What to Expect and Recovery

Surgical treatment for hydrosalpinx typically involves minimally invasive methods such as laparoscopy or robotic surgery. During laparoscopic salpingectomy, small incisions, usually around 5 mm in size, are made, though slight variations may occur depending on the surgeon and techniques used. Due to the smaller wounds, post-operative recovery is generally faster, requiring hardly any bed rest, and patients can often return to their normal activities sooner.

Living with Hydrosalpinx: Is Removal of the Fallopian Tubes Always Necessary?

Living with hydrosalpinx can cause various problems, including reduced fertility, an increased risk of ectopic pregnancy, and pelvic pain and discomfort. While surgical removal of the affected fallopian tubes (salpingectomy) is often recommended if the patient experiences symptoms such as pelvic pain or before undergoing assisted reproductive technology like IVF to improve success rates. The decision to remove the tubes depends on factors such as the severity of hydrosalpinx, individual health circumstances, and the patient’s fertility goals. If the hydrosalpinx is small and the woman does not experience any symptoms, there may be no urgency for surgical removal. However, regular monitoring with ultrasound is necessary to monitor any changes over time.