Every month during ovulation, an egg is produced by one of the ovaries. The mature egg is carried from the ovary to the uterus through a thin oviduct or fallopian tube. When a blockage prevents the egg from traveling down the tube then the woman is having blocked fallopian tube, also known as tubal factor infertility or hydrosalpinx. This can occur on one or both sides.

• Hydrosalpinx simplex is characterized by excessive distension and thinning of the wall of the uterine tube, the plicae being few and widely separated.
• Hydrosalpinx follicularis: A tube without any central cystic cavity, the lumen being broken up into compartments as the result of the fusion of the tubal plicae.
• Sactosalpinx: Dilation of the inflamed uterine tube by retained secretions [saktos = stuffed).

Hydrosalpinx commonly results from a prolonged untreated infection of the fallopian tubes. Common causes are:

• Sexually transmitted diseases such as chlamydia or gonorrhea
• Unsafe Abortions
• Abdominal surgeries – Ruptured appendix
• Previous tubal surgeries
• Pelvic Endometriosis
• IUD’s
• Tubal tuberculosis

Blocked tubes are diagnosed by following tests:

• Ultrasonography
• CT
• MRI
• HSG (Hysterosalpingogram)
• Laproscopy

Hysterosalpingography is a procedure used to diagnose the shape of the uterus and the shape and patency of the fallopian tubes. This test uses X-rays along with a dye to look into the uterus and the fallopian tubes. The whole process takes around 5-10 minutes and patient is allowed to go home the same day.

In the presence of hydrosalpinx the pregnancy rate and implantation rate is reduced by 50% and the risk of spontaneous abortions is doubled. Many studies have shown patients with hydrosalpinx have lower pregnancy rates when compared with patients with tubal infertility without hydrosalpinx.

Both bilateral hydrosalpinx and large size hydrosalpinx visible on ultrasound are associated with a significant reduction in pregnancy rate as compared to unilateral hydrosalpinx and hydrosalpinx not visible on ultrasound.

The risk of ectopic pregnancy and miscarriage rate is not affected by presence of hydrosalpinx. The negative effect of hydrosalpinx was also seen in patients who underwent frozen embryo transfer, suggesting that it is the failure of embryo implantation and not oocyte quality that decreases the reproductive outcome. The tubal fluid is believed to be the main culprit behind the negative effect of hydrosalpinx on the pregnancy rate. That’s all about blocked tubes diagnosis.