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Hydrosalpinx - The Silent Contributor to Infertility

Almost all couples eager to have their babies know how important fallopian tubes are in the progress of getting pregnant. A large group of women with infertility are suffering from fallopian tube diseases: tubal adhesions, tubal blockage, and hydrosalpinx. Hydrosalpinx can even reduce the chance that IVF working if patients want to conceive in this way.

Function of fallopian tubes

The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges (singular salpinx) are two very fine tubes lined with ciliated epithelia, leading from the ovaries of female mammals into the uterus, via the utero-tubal junction. In non-mammalian vertebrates, the equivalent structures are the oviducts.

Fallopian tube produces and secretes substance which is necessary to the travelling of egg and sperm, and the fertilized egg. The egg escaped from the ovary is caught by the fimbriated end of fallopian tube and travels to the ampulla of the uterine tube where typically the sperm are met and fertilization takes place. This is how fertilization occur. Any malfunction or malformation of fallopian tube can contribute to infertility.

Several studies have shown that IVF patients with untreated hydrosalpinx have lower conception rates than controls and it has been speculated that the tubal fluid that enters the endometrial cavity alters the local environment or affects the embryo in a detrimental way.

What causes hydrosalpinx?

Hydrosalpinx is often caused by inflammation, or to say, a pelvic inflammatory disease. When the inflammation has just developed, the fimbrial end and isthmus can be adhesive and blocked.

While the ciliae of the inner lining (endosalpinx) of the fallopian tube beat towards the uterus, tubal fluid is normally discharged via the fimbriated end into the peritoneal cavity from where it is cleared. If the fimbriated end of the tube becomes agglutinated, the resulting obstruction does not allow the tubal fluid to pass; it accumulates and reverts its flow downstream, into the uterus, or production is curtailed by damage to the endosalpinx. This tube then is unable to participate in the reproductive process: sperm cannot pass, the egg is not picked up, and fertilization does not take place.

As the hydrosalpinx develops, the tube is filled with fluid, the wall of fallopian tube expands and becomes thinner. Meanwhile, the tube is secreting less elements which are necessary for the spem, egg, and fertilized egg to live and grow. This is one of the major cause of embryotoxicity, resulting abnormal development or death of embryo.

How does hydrosalpinx affect the development of embryo?

A research of mice embryo found that higher concentration of hydrosalpinx fluid brings a greater inhibition of the development of embryo. If the concentration of hydrosalpinx fluid is higher than 50 percent, development and outgrowth of the embryo is impeded. If the hydrosalpinx fluid flows into the uterus, implantation failure may occur. Very slight hydrosalpinx can reduce the chance of successful implantation and increase the risk of miscarriage.

How does hydrosalpinx affect sperm?

There’re lots of reports announcing that hydrosalpinx fluid is toxic to sperm. Research found that the motility of sperm is lower in hydrosalpinx fluid than it in normal tubal fluid. Several studies have revealed the adverse effects of hydrosalpinx fluid on sperm motility and survival.

How to get pregnant with hydrosalpinx?

Many specialists advocate that prior to an IVF attempt, the hydrosalpinx should be removed. It is still contentious issue that if it’s better to remove the tube with hydrosalpinx before IVF or not. Alternative management of keeping hydrosalpinx fluid from affecting embryo development includes: clipping the tube, drawing the fluid out through vagina, constructing an artificial opening at the terminal part of ampulla. However, there’s still no exacting standards to meet on how IVF outcome can be boosted.

Hydrosalpinx is commonly treated with laparoscopy, along with the treatment there’s some handicap. Herbal formulas can be considered as alternatives for women with infertility who don’t want to undergo laparoscopy. Fuyan Pill is often recommended for treating fallopian tube diseases like hydrosalpinx.


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