There are many causes of infertility, including pelvic tubal factors, ovulation disorders, and low sperm count in the male partner. Tubal diseases account for about 1/3 of female infertility factors, and 10-30% are caused by hydrocele in the fallopian tubes. In the clinic, many couples have a lot of questions about whether to deal with hydrosalpinx before IVF fertilization. I. What causes hydrosalpinx? Infection is the main cause: upstream infections such as bacteria, virus, protozoa, chlamydia and mycoplasma, which are mostly found in unclean abortions, incomplete abortions, abortions and postpartum infections. Acute pelvic tubal infection may lead to hydrosalpinx if the treatment is incomplete or untimely. How to find hydrosalpinx? The most common and best test is hysterosalpingography (HSG), which has a sensitivity of 65% and a specificity of 83% for the diagnosis of hydrosalpinx. The specificity of vaginal ultrasound for the diagnosis of hydrosalpinx is very high at 100%, but the sensitivity is poor at 34%, in other words, some non-serious hydrosalpinx cannot be seen on ultrasound, as long as the hydrosalpinx can be seen on ultrasound, it means that the degree of hydrosalpinx is more serious. Most of the studies have concluded that severe hydrosalpinx affects the success rate of IVF. Whether it is a fresh cycle or a frozen embryo transfer cycle, hydrocele can lead to a decrease in the rate of implantation, pregnancy and delivery, and an increase in the rate of miscarriage. Among the possible reasons for this are the following: 1. Hydrocele compresses the blood vessels of the ovaries, reducing the blood supply to the ovaries and affecting the ovarian response to ovulation-promoting drugs, resulting in slow follicular development and a decrease in the number of eggs obtained. 2. The fluid may back up into the uterine cavity, creating a “flushing” effect that affects embryo implantation. 3. The endometrium’s ability to accept embryos is reduced, which means that the endometrium is less tolerant, reducing the chance of embryo implantation. 4. The damaged tubal fluid may contain microorganisms, tissue fragments, lymphocytes and other toxic substances, which may have adverse effects on both the endometrium and embryo development when they flow into the uterine cavity. Also some cytokines, prostaglandins, leukocyte chemokines and other inflammatory mediators can interfere with the function of the endometrium. This shows that it is necessary to treat fluid in the fallopian tubes, especially the more severe ones, before proceeding to IVF for pregnancy. What are the methods of treatment? Medication: A large part of hydrosalpinx is caused by chlamydial infection, so it is necessary to check whether there is chlamydial infection at present, and those who are positive should be treated, in addition to using some Chinese medicine to activate blood circulation and remove blood stasis. However, the effect of medication on the formed hydrosalpinx is minimal. The effect of tubal drainage is uncertain because it can recur even after puncture and drainage. Therefore, tubal drainage is not the ideal treatment. Hysterolaparoscopic surgery: It is currently recognized as the most effective treatment method. Numerous studies have shown that surgery for hydrosalpinx, either surgical removal or proximal ligation, can significantly improve the outcome of IVF. However, not all patients with hydrocele result in IVF failure, and tubal resection deprives the patient of the chance of natural conception forever (although it does not affect physical health, even if the chances of preserving conception are low,) thus increasing the psychological burden of infertile patients, so it is also important not to blindly remove the hydrocele. 1.Advantages of tubal resection: removal of bilateral fallopian tubes in severe hydrocele can not only improve the outcome of IVF, but also reduce chronic pelvic pain in some patients and reduce the chance of inflammatory recurrence and tubal ectopic pregnancy. 2. Disadvantages of tubal resection: First, it increases the psychological burden of the patient. Secondly, it may affect the blood supply to the ovaries and decrease the reserve function of the ovaries, and reduce the number of developing follicles and eggs obtained during ovulation promotion. To sum up, whether or not to surgically remove hydrosalpinx should take into account the severity of the hydrosalpinx, the age of the woman, the function of the ovaries and other factors to weigh the pros and cons of surgery for a particular person. If you have a problem in this area, please seek the help of a doctor who can give you a comprehensive assessment and treatment advice through examination, so that you can realize your wish to become a parent soon.