I recently had an HSG performed and discovered that my right tube is completely hydrosalpinx. The left tube has a very small opening. Removal of both tubes has been suggested and then IVF to achieve pregnancy. Whether I decide on IVF or not, is tubal removal necessary for me to have a baby?

D.P.

Attempts to surgically correct hydrosalpinx (a condition in which the fallopian tube is blocked and filled with fluid) are rarely successful. Pregnancy rates are quite low after attempts at surgical correction, and there is a significant risk of ectopic pregnancy. In vitro fertilization (IVF) would be the most appropriate step to help you conceive.

If the fallopian tube is filled with fluid, removal may provide a higher success rate for IVF. Hydrosalpinx fluid contains chemicals called cytokines that interfere with implantation and pregnancy. In women whose hydrosalpinx can be seen on an ultrasound exam, pregnancy rates are lower and miscarriage rates are higher. The importance of hydrosalpinx is less clear when it is evident only during HSG (an X-ray test that involves injecting fluid into the tubes to see if they are clear).

More research is needed to clarify the role that hydrosalpinx plays during infertility treatment and miscarriage. Your own physician is best able to evaluate your situation and determine if removal of the affected fallopian tube, or both tubes, is advisable.