Human conception truly is an amazing thing, and the fact any of us are able to get conceive is pretty unreal. When you think about all the biological processes that need to properly function in just the right way and at just the right time, it’s a bit mind blowing.
So many healthy functions need to take place to get pregnant — ovaries producing eggs, unblocked fallopian tubes for eggs to travel through, healthy sperm meeting the egg, proper implantation in the uterine wall — that when just one of those isn’t working, your odds of conceiving drop dramatically.
For that reason, it’s not surprising that 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant, according to the Centers for Disease Control and Prevention (CDC).
But of all those processes that need to take place for conception to occur, healthy fallopian tubes which are free from any blockage are often overlooked as a reason for infertility. And it’s exactly that — a certain type of tube blockage — which would prevent sperm and egg from ever meeting.
That kind of blockage is called hydrosalpinx (salpinx is Greek for fallopian tube,) and it happens when one or both fallopian tubes become blocked and filled with fluid, and it severely hinders the journey of egg to sperm and vice versa.
Most women experience few, if any, symptoms with hydrosalpinx, and it can be caused by several different and varied things. Some of those include a long untreated infection or sexually transmitted disease, endometriosis, pelvic inflammatory disease, abdominal surgery, or a ruptured appendix — all of which cause an inflammatory response to occur inside the tube.
That response subsequently causes the tube’s fimbria (finger like projections in the tube) to stop functioning, often closing or blocking the tube and filling with fluid, or sticking together and thus unable to direct the egg down the tube. The affected tube usually ends up distended and even if only one tube is infected, there may be residual damage to the other.
A thorough infertility workup that includes tests like a sonohysterosalpingography (method of assessing fallopian tube health), a hysterosalpingogram (X-ray of uterus and tubes,) a laparoscopy (surgical procedure where a camera is inserted to see organs,) or an ultrasound can all reveal to your doctor if any blockages are present, and what treatments may be your best options.
The most common treatment for hydrosalpinx is a type of tubal corrective surgery to remove adhesions causing the blockage, or a salpingectomy which removes the tube entirely. Another possible treatment is sclerotherapy, which involves the use of an an ultrasound-guided needle to remove fluid out of the affected tube. A chemical called a sclerosing agent is then injected, which is used to prevent future blockages.
Treatments like these need to be done before attempting in vitro fertilization (IVF) for successful pregnancy to occur, because if left untreated, affected tubes can leak into the uterus, hindering implantation. IVF success rates are higher for women who have had hydrosalpinx treated prior to IVF, and although conception is possible without treatment, complications and early pregnancy loss are higher if the hydrosalpinx is left untreated.
When seeking fertility help, it’s vital to have thorough discussions with your team of doctors about all your diagnostic options, as well as your treatment options, ensuring that all bases have been covered. Each and every step in the conception process needs to be evaluated and examined, and that includes examination of your fallopian tubes to rule out hydrosalpinx. And if your concerns and questions are not being heard and answered with compassion and dedication, find another doctor.