What is the fallopian tube?
With the term aqueduct we describe a clinical condition, which is characterized by the collection of fluid in one or both fallopian tubes, due to obstruction of the abdominal orifice (bellows). The word comes from the Greek "hydro" (water) and "salpinx" (tube, specifically fallopian tube). This condition can affect just one or both fallopian tubes. Many times, the problematic fallopian tube can grow and reach a size of several centimeters.
What is the cause of hydrops?
There can be more than one cause of hydrops, but the most common cause is a previous pelvic infection, the most common of which are chlamydia and gonorrhea. Previous pelvic surgery, adhesions, endometriosis, and certain tumors can also cause hydrops.
What are the symptoms of hydrops?
In many cases, hydrops does not cause symptoms. However, when symptoms are present, the main complaint is pelvic pain, pain during intercourse or even fever. Often, infertility is a symptom in itself and is the clue that leads to the diagnosis of hydrops.
What methods are used to diagnose hydrops?
The most useful method for diagnosing hydrops is HSG (hysterosalpingography). HSG is a type of fluoroscopy (x-ray performed using a contrast medium). HSG is good at assessing tubal patency (free flow through the fallopian tubes) because the fertility specialist performing the procedure can see the movement of the contrast dye through the tubes. If this flow is blocked, it will be clearly visible. Ultrasound can be used to make a confirmatory diagnosis and eliminate the possibility of a false positive HSG result.
What is the effect of hydrops on fertility?
The ability to conceive with a tubal fallopian tube varies depending on the severity of the obstruction and the choice of treatment. Without treatment, pregnancy is possible, but the chances of complications, such as miscarriage, are greater. With treatment, the outlook is much better, especially with IVF. A hydrops can also adversely affect fertility treatment. According to the National Institutes of Health, having amniotic fluid in a woman undergoing assisted reproductive technologies such as IVF reduces the success of such treatments by half compared to women who do not have amniotic fluid.
But there are two fallopian tubes, so there shouldn't be a problem, right?
The very presence of hydrops can negatively affect fertility. Also, bilateral hydrocephalus (where both fallopian tubes are blocked) is quite common.
If the fertility specialist diagnoses hydrops, will IVF allow me to have a normal pregnancy?
When a person undergoes in vitro fertilization (IVF), doctors retrieve an egg and fertilize it artificially. They then have to transfer the embryo back into the uterus. The fallopian tube can affect the success of this transfer. Removing the fallopian tube before an embryo implants can improve IVF success rates. For this reason, doctors often recommend completing the surgery before undergoing IVF treatment. Additionally, fluid blockage can lead to an ectopic pregnancy, which occurs when a fertilized egg gets stuck in the fallopian tube and begins to develop into an embryo. This type of pregnancy cannot be continued safely as it will result in fetal loss. Without treatment, it can also be fatal for the pregnant woman.
Treatment of hydrops
Treatment for hydrops varies depending on the severity of the blockage. A doctor may recommend laparoscopic surgery to remove scar tissue or other adhesions that could affect fertility. Another type of surgery, known as a salpingectomy, involves removing all or part of the affected tube. Laparoscopic salpingectomy is performed under general anesthesia and the surgery usually takes less than an hour. You should allow a recovery time of about three weeks. Removal of the tubal fallopian tubes often dramatically increases IVF success rates. This procedure can help restore fertility. If the cause is endometriosis, doctors can remove the endometrial growths. In cases where pelvic inflammatory disease (PID) is the cause, a doctor may prescribe a course of antibiotics to treat any remaining infections.
Another possible treatment is sclerotherapy, which uses an ultrasound-guided needle to draw fluid from the affected tube. Doctors then inject a special chemical called a hardening agent, which should prevent the fluid from building up again.
How can I learn more about the diagnosis and treatment of hydrops?
Schedule a consultation! Contact today the Center for Reproductive Medicine “Dr. Alexandros Traianos" and together we will help you find the answers you are looking for. For information call the phone 
(+30) 2310 277 032 or send a message to 
email alexandrostraianos@gmail.com.
