in opening tube or tubes
blocked at the fingered end
(hydrosalpinx or hydrosalpinges) depends on the stage of tubal damage
and on other infertility factors.
The stage (mild, moderate, severe) is determined by the health of
the inside of the tube (folds and cilia) and amount of pelvic scarring.
The folds and cilia are the active system that sweeps the egg to the
uterus. We can see the folds, but the cilia are microscopic.
hydrosalpinx with mild
damage is associated with few filmy adhesions, good folds and no internal scar.
60% of women can expect to have babies while 3% will have tubal pregnancies.
Surgery is better than IVF.
damage is associated with more filmy adhesions, few folds and no internal scar.
20% of women can expect to have babies while 15% will have tubal pregnancies.
IVF is usually better than surgery. Removing the tube or tubes is reasonable.
damage is associated with dense adhesions, rare folds and increased internal
scar. 3% of women can expect to have babies while 15% will have tubal
pregnancies. When both tubes are hydrosalpinges with severe damage, IVF is better than surgery and may be the only reasonable
option. Removing the tubes is often helpful especially with lateral pelvic
pain and tenderness.
folds can often be seen on an HSG (hysterosalpingogram).
The folds are seen as alternating dark and white lines inside the tube and run
in the same direction as the tube. The folds are the part of the tube that have cilia that sweep the
egg to the uterus. If there are no folds and no cilia, the egg has no system to
move it on. When folds are seen, the tubes are more healthy than when
not seen. Seeing folds can be seen with healthy tubes, mild damage or moderate damage.
the folds are gone, the tube will have no inner lines on an HSG. This creates a
flat balloon-like appearance. This balloon appearance suggests moderate
or severe damage to the folds.
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