Revised 2023


The fallopian tubes are attached to the uterus (womb) on the left and right sides. Normally, the fallopian tube picks up an egg as it is released (ovulated) from the ovary each month, and this is usually where sperm and egg meet. Sperm travel from the vagina through the cervix and uterus to eventually meet the egg in one of the two tubes. Fertilization occurs when the egg and sperm join together to form an embryo (fertilized egg).

The embryo then travels through the tube into the uterus. When it reaches the uterus, it can start attaching to the wall of the uterus to develop into a baby.
Fig1-hydrosalpinx.webp

Damage and blockage of the end portion of a fallopian tube can cause it to become filled with fluid; the swollen and fluid-filled tube is called a hydrosalpinx. A normal pregnancy in the uterus may not occur with hydrosalpinx because the tube can be severely damaged and not work properly. A pregnancy may develop in the tube (ectopic pregnancy), which can be life-threatening. In addition, when the tube is blocked, secretions that collect in the tube may backflow into the uterus and prevent a pregnancy from implanting into the uterus.

What causes a hydrosalpinx?

Hydrosalpinx can be caused by an old infection in the fallopian tubes, sometimes a sexually transmitted infection. Other causes include previous surgery (particularly surgeries on the tube), severe adhesions of your pelvis, endometriosis, or other sources of infection such as appendicitis.

What are the symptoms of hydrosalpinx?

Most people do not have any symptoms other than fertility problems. In some people, an ectopic pregnancy may be the first sign of a problem with their tubes. Occasionally, some people may complain of regular or constant pain in their pelvis or lower belly, which may get worse during and after their period. A vaginal discharge can also be associated with this condition.

How will my doctor diagnose hydrosalpinx?

There are three ways to check if one or both of your tubes are blocked and if you have hydrosalpinx; one or more may be performed for diagnosis:

Hysterosalpingogram (HSG) (x-ray)

fig2-hydrosalpinx.webp

The doctor will inject a special liquid that shows up on an x-ray into your uterus through your cervix (lower part of the uterus) and then take an x-ray (called a hysterosalpingogram or HSG) to see where the liquid goes. If your fallopian tubes are open, the liquid will flow out of the ends of the tube into the pelvic cavity. If the tubes are blocked, the liquid will be trapped and your doctor will be able to tell that you have a hydrosalpinx. However, this test can sometimes falsely suggest that the tubes are blocked, and sometimes results can be difficult to interpret. For more information about HSG, please see the ASRM fact sheet titled Hysterosalpingogram (HSG).

Ultrasound

Your doctor may be able to detect the presence of a hydrosalpinx on ultrasound. If your tube appears enlarged on ultrasound, this usually indicates a more severe hydrosalpinx.

Surgery (laparoscopy)

Your doctor will make a small opening in your belly and insert a special telescope (laparoscope) to look at your uterus and fallopian tubes. During this surgery, the doctor can look at your fallopian tubes to see if they are blocked. Usually the doctor inserts a dye through the cervix into the uterus and fallopian tubes to confirm that the dye passes through the ends of the tubes. For more information about laparoscopy, see the ASRM booklet titled Laparoscopy and Hysteroscopy.

If I have hydrosalpinx, can I have a baby?

If both of your fallopian tubes are completely blocked, an egg cannot travel through them to your womb.

You will need to be treated by a fertility specialist to become pregnant. Your doctor may occasionally be able to open the tubes with surgery.

If there is too much damage to the tube(s), you will need treatment that does not involve the tubes to help you get pregnant, such as in vitro fertilization (IVF). In this procedure, your egg is joined (fertilized) with sperm in the laboratory. Then the doctor places the fertilized eggs (embryos) into your womb. Your doctor may recommend that your hydrosalpinx is removed or separated from the womb before you start IVF treatment, as the hydrosalpinx may lower your chance of pregnancy.

Female Fertility

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SART Fertility Experts - Wellness and Fertility: Diet, Sleep and Exercise

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SART Fertility Experts - Preconception Counseling

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Stress and infertility

It is not clear how exactly stress impacts fertility. Read the Fact Sheet
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Optimizing Natural Fertility

Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant) View the fact sheet
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Am I Ovulating?

Ovulation is the release of an egg from a woman’s ovaries and is essential for getting pregnant. View the Fact Sheet
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Abnormalities of the Female Reproductive Tract (Müllerian Anomalies)

Sometimes the uterus and fallopian tubes may not form like they should. These malformations are called müllerian anomalies or defects. Müllerian anomalies may make it difficult or impossible to become pregnant. View the Fact Sheet
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Conditions Treated with Surgery on the Fallopian Tubes and Ovaries

Surgery can be used to treat problems with the ovaries or fallopian tubes, such as cysts, endometriosis, or infections. View the Fact Sheet
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Diagnostic Testing for Infertility

An evaluation of a woman for infertility is appropriate for women who have not become pregnant after having 12 months of regular, unprotected intercourse. View the Fact Sheet
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Dilation and Curettage (D&C)

“Dilation and curettage” (D&C) is a short surgical procedure that removes tissue from your uterus (womb). You may need this procedure if you have unexplained or abnormal bleeding or if you have delivered a baby and placental tissue remains in your womb. View the Fact Sheet
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Evaluation of the Uterus

If you haven’t been able to get pregnant after trying for 6 months, some tests can be done to help find the reason. Your doctor may test your hormone levels, your partner’s sperm, and your reproductive organs (ovaries, fallopian tubes, and uterus [womb]). View the Fact Sheet
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Female Cancers, Cryopreservation, and Fertility

Yes! New technology lets your doctor remove and freeze eggs, fertilized eggs (embryos), or ovarian tissue before treating your cancer. This way, you may be able to have children after your treatment. View the Fact Sheet
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Fertility Drugs And The Risk of Multiple Births

Infertility treatments that cause multiple eggs to develop make it more likely that you will become pregnant with twins, triplets, or more. This is called multiple gestation. View the Fact Sheet
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Hypothyroidism and pregnancy: what should I know?

Hypothyroidism (underactive thyroid) is when the thyroid gland produces less  thyroid hormone than it should. View the Fact Sheet
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Ovulation Detection

Ovulation, the release of an egg from its follicle in one of a woman’s two ovaries, is one of the most important factors in conceiving a child. View the fact sheet
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Weight and fertility

One of the easiest ways to determine if you are underweight or overweight is to calculate your body mass index (BMI). View the fact sheet
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SART Fertility Experts - Endometriosis

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SART Fertility Experts - IVF: Cycles of Hope and Heartbreak

Does stress cause infertility or is it the other way round?  Listen to the Episode
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What is Recurrent Pregnancy Loss (RPL)?

This is a condition when a woman has 2 or more clinical pregnancy losses (miscarriages) before the pregnancies reach 20 weeks. View the fact sheet
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SART Fertility Experts - Fibroids and Fertility

Fibroids and their impact on fertility are discussed in this episode featuring Dr. Elizabeth Stewart, interviewed by host Dr. Brooke Rossi.  Listen to the Episode
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Infertility: an Overview (booklet)

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
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Infertility

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Basic Infertility Evaluation

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Watch Video
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Fibroid Tumors

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Infertility Treatments

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various treatments for infertility. Watch Video
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Understanding Fertility

In this video series, Dr. Roger Lobo explains the basics of infertility, including causes, treatments and coping methods. Watch Video
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Surviving the Roller Coaster Emotions of Infertility Treatment

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Endometriosis (booklet)

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Causes of Female Infertility

Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of female infertility. Watch Video
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FAQ About Infertility

Infertility is not an inconvenience; it's a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Learn the facts
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Female Fertility Infographics

ASRM has prepared infographics to illustrate the subject of Female Fertility better. View the Infographics
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Ovarian Reserve Infographics

ASRM has prepared infographics to illustrate the subject of Ovarian Reserve better. View the Infographics

Fact Sheets/Booklets

View more fact sheets and booklets written by the ASRM Patient Education Committee.
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Menopausal Transition (Perimenopause): What Is It?

The menopausal transition (perimenopause) is the period that links a woman’s reproductive (childbearing) years and menopause.
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Osteoporosis

Osteoporosis and osteopenia are conditions of having low bone mass (density).
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Stress and infertility

It is not clear how exactly stress impacts fertility.
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Optimizing Natural Fertility

Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant)

Resources For You

The American Society for Reproductive Medicine (ASRM) is committed to providing patients with the highest quality information about reproductive care.

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