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Female Infertility


A  fallopian tube that is blocked or damaged on the open end is called a hydrosalpinx

Fallopian tubes serve an important function, as they are the pathway through which the sperm, egg, and embryo have to travel.  When ovulation occurs, the egg is picked up by the finger-like projections at the end of the tube.  The egg then moves toward the uterus.  When a couple has intercourse, the sperm swim through the uterus and then out into the fallopian tube where they encounter the egg. Fertilization occurs in the tube and then the early embryo is propelled down the tube into the uterus where it will hopefully attach to the uterine wall.

A normally functioning tube is critical to the normal fertility process.

Tubes can be damaged as a result of infection (like gonorrhea or chlamydia), previous pelvic or abdominal surgery, scarring that results from endometriosis, or from other causes.  A tube that is blocked at the end nearest the ovary (the “distal end”) is called a hydrosalpinx.

This condition can cause infertility by one of several means.  First of all, as the tube is blocked, there is no way for the egg to get picked up at the time of ovulation.  Although the egg can live on its own for 24-48 hours, it will soon die in the patient’s pelvis (abdominal cavity) without ever having the opportunity to meet up with sperm.

Secondly, the lining of a normal tube makes fluid every day.  This fluid passes out of the distal end of the tube into the pelvis, where it is processed normally by the body.  When the distal end of the tube is blocked, that fluid has no way to pass into the pelvis.  It therefore builds up, causing the tube to dilate (or swell).  The fluid then gradually migrates into the uterus, where it can prevent implantation of an embryo even if the other tube is completely normal.

Although the exact mechanism by which the hydrosalpinx decreases the chance for pregnancy remains controversial, many studies have shown that pregnancy rates, even with IVF, in the presence of a hydrosalpinx are reduced by approximately 50%.

We usually recommend either surgical repair, if possible, or removal of the hydrosalpinx prior to beginning any significant fertility treatment.

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