Hydrosalpinges: Repair or excise

Abstract

Tubal disease accounts for up to one-third of female factor infertility. The majority of tubal disease is secondary to distal obstruction and often a result of prior pelvic infection, ectopic pregnancy, or endometriosis. Accurate diagnosis is essential as the location and extent of distal tubal disease influences treatment planning. When evaluating for tubal patency, hysterosalpingography is the recommended first-line imaging study as it is low risk, cost-effective, and carries the benefit of improving subsequent fertility. This chapter examines the diagnosis of hydrosalpinges, the impact on pregnancy, reviews surgical options for reparative distal tubal surgery, and the factors clinicians must consider when deciding between surgical repair and in vitro fertilization.