Tubal factor infertility is one of the main causes of female infertility, with hydrosalpinx being one of the most serious tubal pathologies. In vitro fertilization-embryo transfer (IVF-ET) is the most effective method to treat tubal infertility. However, compared to women with tubal infertility due to simple tubal obstruction, women with tubal infertility due to hydrocele have significantly lower IVF-ET embryo implantation rates and clinical pregnancy rates, and higher miscarriage and ectopic pregnancy rates. Hydrocele is a special type of tubal obstruction that not only affects the tubal transport function, but also causes inflammation of the endometrium due to the accumulation of inflammatory fluid in the fallopian tubes, which affects the endometrial tolerance and can poison the embryo and mechanically flush the embryo. In addition, hydrosalpinx can also compress the blood vessels supplying the ovaries and affect the function of the ovaries. Common treatments for hydrosalpinx include tubectomy, tubal ligation, tubal ostomy, ultrasound-guided hydrosalpinx aspiration, tubal embolization, etc. Many women hold concerns about the procedures performed to deal with tubal effusion, such as the tubal ligation mentioned in this article. It should be noted that there is no denying that any operation or surgery can cause harm to the body and there is no operation or surgery that can cause absolutely no harm. However, if the benefits of the procedure outweigh the disadvantages caused by the disease, then we believe that the procedure is worthwhile and necessary. The negative impact of tubal effusion on female fertility is unquestionable and it is well established that tubal effusion management improves IVF-ET outcomes. Therefore, for infertile women who want to have a good clinical or pregnancy outcome, it is important to actively manage tubal effusion if it is present. Tubal ligation is one of the commonly performed methods. This procedure blocks the inflammatory fluid in the fallopian tubes from entering the uterine cavity, but the fluid in the tubes is not removed, potentially causing pelvic inflammation, and the fluid in the tubes may continue to compress the blood vessels supplying the ovaries, affecting ovarian function. Of course, there are several other methods that have their own advantages and disadvantages, and the final method to be adopted will be determined by the clinician according to the condition.