The endometrium is the direct site of embryo implantation and growth. During in vitro fertilization-embryo transfer (IVF-ET), embryo quality and endometrial tolerance are two key factors affecting embryo implantation. Numerous studies have found that hydrosalpinx affects the expression of molecules and genes related to endometrial tolerance, reducing the success rate of IVF-ET. Hydrosalpinx is a more common type of chronic tubal inflammation. It is a pathological process of distal tubal obstruction caused by miscarriage, induction of labor, impure intercourse, pelvic infection, etc., which causes the tubal wall to dilate and form fluid. In vitro fertilization-embryo transfer provides a viable solution for infertility caused by tubal factors. Regarding the effect of tubal effusion on IVF pregnancy outcome, research findings show that tubal effusion decreases the rate of IVF-ET implantation and pregnancy and increases the rate of miscarriage, advocating that tubal effusion should be treated before IVF-ET, with surgery generally being the treatment of choice. There are different opinions on the choice of surgical treatment for hydrosalpinx. Commonly used surgical procedures include transvaginal ultrasound aspiration of hydrosalpinx, salpingo-oophorectomy, salpingo-oophorectomy, proximal tubal ligation, and tubal embolization in recent years. So, what are the characteristics of each of these treatment methods? 1. Transvaginal ultrasound aspiration of hydrocele The mechanism may be that it reduces the pressure in the fallopian tube, prevents the flow of hydrocele to the uterine cavity and avoids the toxic effect of the fluid in the tubal fluid on the embryo. However, this method is prone to the recurrence of hydrosalpinx, so sometimes multiple punctures and aspirations are needed. In 1994, Verhulst et al. reported that removal of the hydrosalpinx would not affect ovarian function and might make it easier to monitor follicular development, with a significantly higher clinical pregnancy rate than before surgery. Since then there have been numerous similar reports. However, a large number of studies have also concluded that oophorectomy may disrupt the blood supply to the ipsilateral ovary, affecting hormone production and follicle development in that side of the ovary, so oophorectomy is not the best option. This procedure preserves the fallopian tube and avoids affecting the blood supply to the ipsilateral ovary and follicle development, and increases the pregnancy rate of embryo transfer. 4. Proximal tubal ligation Some studies claim that there is no significant difference between proximal tubal ligation and salpingo-oophorectomy on ovarian blood supply and on IVF outcome of patients. 5. In addition, the latest study shows that tubal embolization has the characteristics of simplicity, safety and economy compared with the other 4 traditional procedures, and not only does not affect ovarian function, but also can significantly increase the clinical pregnancy rate and eliminate the occurrence of tubal pregnancy, which has good application prospects. The choice of treatment for patients with tubal effusion before sexual IVF-ET should be based on the location and severity of the tubal effusion and the combination of other infertility factors, etc., and the best individualized fertility treatment plan should be chosen.