Hydrosalpinx Explained
Understanding the Condition, How It Can Affect Fertility, and What Treatment Options May Be Available
Being told you have a hydrosalpinx can feel overwhelming, especially if you've never heard the word before.
Many people only discover they have a hydrosalpinx during fertility investigations. Others may have experienced symptoms for years without realising there was an underlying cause.
This guide explains what a hydrosalpinx is, why it happens, how it can affect fertility, and the treatment options your healthcare team may discuss with you.
What is a Hydrosalpinx?
A hydrosalpinx is a Fallopian tube that has become blocked and filled with fluid.
Normally, the Fallopian tubes provide the pathway where an egg and sperm can meet. They also help carry a fertilised egg towards the uterus.
When a tube becomes blocked, fluid can build up inside it. Over time, the tube may become swollen and lose much of its normal function.
A hydrosalpinx can affect one Fallopian tube (unilateral) or both (bilateral).
What Causes a Hydrosalpinx?
A hydrosalpinx develops after damage or inflammation affects the Fallopian tube.
Possible causes include:
previous pelvic infections
untreated sexually transmitted infections (such as chlamydia)
previous abdominal or pelvic surgery
endometriosis
pelvic inflammatory disease (PID)
severe inflammation following infection
Sometimes, the exact cause is never identified.
What Are the Symptoms?
Some people experience no symptoms at all.
Others may notice:
pelvic pain
lower abdominal discomfort
unusual vaginal discharge
pain during intercourse
irregular discomfort around ovulation
difficulty becoming pregnant
Many people only discover they have a hydrosalpinx during fertility investigations.
How Can a Hydrosalpinx Affect Fertility?
A healthy Fallopian tube plays an important role in natural conception.
When a hydrosalpinx is present:
sperm and egg may be unable to meet
a fertilised egg may struggle to travel to the uterus
inflammation may affect the environment within the pelvis
Research has also shown that the fluid inside a hydrosalpinx may reduce the chances of an embryo implanting successfully during IVF if the affected tube remains in place.
Not everyone with a hydrosalpinx experiences infertility, but it is recognised as an important factor that should be assessed as part of fertility investigations.
How Is a Hydrosalpinx Diagnosed?
Several investigations may help identify a hydrosalpinx.
Ultrasound Scan
Sometimes a swollen Fallopian tube can be seen on a pelvic ultrasound.
However, a normal ultrasound does not rule out a hydrosalpinx.
HSG (Hysterosalpingogram)
An HSG is an X-ray procedure in which dye is passed through the uterus and Fallopian tubes.
If the dye cannot pass through the tube as expected, this may suggest a blockage.
An HSG can provide valuable information, but further investigations may sometimes be recommended.
HyCoSy
Some fertility clinics use a specialised ultrasound procedure called a HyCoSy (Hysterosalpingo-Contrast Sonography) to assess whether the Fallopian tubes are open.
Laparoscopy
In some cases, a laparoscopy may be recommended to confirm the diagnosis, assess the pelvis in more detail, or treat other conditions such as endometriosis at the same time.
What Treatments Are Available?
Treatment depends on your symptoms, whether one or both tubes are affected, and whether you're trying to conceive.
Options may include:
Monitoring
If a hydrosalpinx is small, not causing symptoms, and fertility is not currently a concern, your healthcare team may recommend monitoring.
Surgery
For people trying to conceive—particularly before IVF—surgery may be recommended.
This may involve:
removing the affected Fallopian tube (salpingectomy)
blocking the tube close to the uterus
in selected cases, attempting to repair the tube
Your specialist will explain which option is most appropriate for your situation.
IVF
If both tubes are severely damaged, IVF may be recommended.
Where a hydrosalpinx is present, specialists may discuss treating or removing the affected tube before IVF because this can improve the chances of a successful pregnancy in some people.
Can You Still Get Pregnant Naturally?
Yes—some people with a hydrosalpinx do conceive naturally, particularly if only one tube is affected and the other tube is healthy.
However, if both tubes are blocked, natural conception is much less likely because the egg and sperm cannot meet in the usual way.
Your fertility specialist can explain what this means in your individual circumstances.
Questions You May Wish to Ask Your Doctor
You may find it helpful to ask:
Is one tube affected or both?
What do my scan results show?
Do you know what caused the hydrosalpinx?
Is surgery recommended?
Would removing the tube improve my chances of pregnancy?
If I'm considering IVF, should treatment of the hydrosalpinx happen first?
What are the risks and benefits of surgery?
What are my options if both tubes are affected?
Key Points
✔ A hydrosalpinx is a blocked, fluid-filled Fallopian tube.
✔ Some people have no symptoms and only discover it during fertility investigations.
✔ It can reduce the chances of natural conception and may also affect IVF success if left untreated.
✔ Ultrasound, HSG, HyCoSy and laparoscopy may all play a role in diagnosis.
✔ Treatment depends on your individual circumstances and future fertility plans.
Related Guides
HSG Explained
Ultrasound Explained
Endometriosis Explained
Laparoscopy Explained
Tube Removal (Salpingectomy)
IVF Explained
Waiting for Results
Read My Story
The information on this website is here to help you understand the medical side of infertility. If you'd like to read the personal story behind why these subjects matter so much to me—including the twists, setbacks and the moments that finally brought answers—you'll find it in my book, Twenty Years to You.
My hope is that, wherever you are on your own journey, you'll find both information and reassurance that you're not alone.