Knowledge Sharing

2018.06.20

Is bilateral hydrosalpinx suitable for reconstruction?

Q:
My fallopian tubes are blocked due to hydrosalpinx. Is this suitable for reconstruction? If so, how’s the successful rate?


A:
Hydrosalpinx refers to water accumulate over the end of the fallopian tube, which causes the end of the fallopian tube is blocked due to swelling and edema over the fallopian tube. Of course, the sequelae of hydrosalpinx is that the eggs discharging from the ovaries cannot enter the fallopian tubes and combine with the sperm. Another sequela is that the water in the fallopian tubes cannot be discharged, which may enter the uterine cavity countercurrently, leading to a negative impact on the implantation of the embryo in the uterine cavity. The treatment of hydrosalpinx is to use laparoscopy to evaluate the severity of tubal edema, and then treat it with laparoscopy. There are various surgical methods depending on the severity of the edema:
 
  1. Mild edema: doctor may perform tubal remodeling or salpingoneostomy to repair the fallopian tube, you need to grasp the opportunity to get pregnant as soon as possible after repair. Patients receiving the intervention have higher risk of ectopic pregnancy. The fallopian tubes can become blocked and edema again over time in some patients.
     
  2. Severe edema: in addition to complete obstruction over the fallopian tube, there is necrosis of the endothelial cells but without end openings over the fallopian tube. In this situation, the fallopian tube cannot be repaired. The treatment can only be performed by removing the fallopian tube or cutting off the junction of the fallopian tube and uterus, which is used to prevent the water cumulating at the fallopian tube and flowing back to the uterine cavity, no longer affect embryo implantation and improve the successful rate of implantation.

In patients with severe hydrosalpinx over bilateral fallopian tube, the in vitro fertilization (IVF) may be used for pregnancy after surgery. If you receive the IVF treatment instead of surgery, the water over the fallopian tube will flow back to the uterine cavity, which may affect embryo implantation and reduce the pregnancy rate by 50%. Therefore, it is recommended that patients with hydrosalpinx should first undergo laparoscopic surgery to improve the uterine implantation environment. A better uterine implantation environment can increase the chance of conception. It is recommended that patients with hydrosalpinx go for a doctor's evaluation for more details.