In recent years, the incidence of infertility has increased with the accelerated pace of life, environmental pollution, changes in dietary structure and changes in people’s fertility concepts. Tubal factor infertility accounts for 25%-35% of female factor infertility. The main causes of tubal infertility are pelvic infection and history of pelvic surgery, appendicitis, history of repeated uterine operations, tuberculosis and endometriosis. Infectious factors account for 50% of the causes of tubal lesions. The epithelium of the fallopian tube is composed of columnar epithelial cells covered with cilia and cilia-free secretory cells. With the peristaltic movement of the fallopian tubes, the cilia oscillate to transport the secretions of the secretory cells and the eggs towards the uterine cavity. During the physiological menstrual cycle, the tubal cells are ciliated while progesterone induces de-ciliations. When the fallopian tubes are damaged during the inflammatory process, a permanent decrease in the number and quality of cilia of the ciliated cells occurs. Lesions and blockages of the fallopian tubes can be proximal blockage and distal blockage or lesions involving the entire fallopian tube. The main goal of surgical treatment is to restore patency to the fallopian tubes so that sperm and eggs can meet and fertilize in the tubes. Hydrosalpinx is caused by adhesions in the pelvic cavity due to pelvic infection and blockage of the distal part of the fallopian tubes, resulting in a gradual accumulation of plasma exudate in the lumen of the fallopian tubes. In addition, after tubal ligation or sterilization, postoperative fluid accumulation in the fallopian tubes is also common, but the damage to the subplasma tissue may be more serious and become a factor affecting the function after tubal reversal. Hydrocele causes thinning of the luminal mucosa, increased spacing of folds, shortening of epithelial cells, and reduction and absence of cilia, all of which may be the result of inflammation and non-infectious factors. The first type is simple hydrosalpinx, which is characterized by thin and transparent tubal walls, a single tubal lumen, flattened and free luminal mucosal folds, and no endometrial adhesions. The second type is cystic hydrosalpinx. It is characterized by a thin tubal wall and focal or extensive adhesions in the tubal mucosa. The third type is thick-walled hydrosalpinx. It is characterized by a tubal wall thickness of more than 2 mm in the abdomen with no mucosal folds or fibrosis of the folds. The severity of the lesion is divided into three degrees. Mild, moderate and severe. Mild: hydrocele diameter <1.5cm, or no hydrocele, tubal umbrella visible, no obvious adhesions around the fallopian tubes or ovaries, normal preoperative hysterosalpingogram (HSG) morphology; Moderate: hydrocele diameter 1.5~3.0cm, structure of umbrella needs to be identified, adhesions around the ovaries or fallopian tubes, but not yet fixed, a few adhesions in the rectal sink of the uterus, normal preoperative HSG morphology Loss. Severe: hydrosalpinx >3.0 cm in diameter, atresia of the umbilical end, not visible, dense adhesions in the pelvic or adnexal area, closed rectal hollow of the uterus, or severe adhesions in the pelvic cavity making the pelvic organs difficult to identify. Treatment of mild tubal effusion For patients with tubal effusion found to be not serious by hysterosalpingography, along with good ovarian reserve and normal male semen routine, treatment of tubal lesions through laparoscopic surgery can be considered first to increase the patient’s chance of natural pregnancy. The distal tubal lesions are mainly atresia of the umbilical end of the fallopian tube and the resulting hydrocele, which is caused by the accumulation of mucosal secretions from the normal or pathological state of the fallopian tube, resulting in dilatation of the fallopian tube and damage to the lumen. Tubostomy can be accomplished by open microsurgery or laparoscopic surgery. The clinical outcome of tubal ostomy depends mainly on the condition of the tubal lesion. The clinical pregnancy rate of tubal ostomy in patients with thin-walled lesions of hydrocele can reach 58%-77% and ectopic pregnancy rate reaches 2%-8%. The prognosis of tubal ostomy in patients with posterior wall lesions of hydrocele is poor, with clinical pregnancy rates of 0-22% and ectopic pregnancy rates of 0-17%. Therefore, the procedure must be fully evaluated for the status of the tubal lesion, combined with the patient’s age, years of infertility, ovarian reserve function and other factors to decide whether to perform a tubal ostomy or a tubal resection or proximal ligation with postoperative IVF. [Ultrasound puncture intervention] With the improvement of vaginal ultrasound and the application of special puncture guides and puncture needles, vaginal ultrasound-guided interventions have become increasingly simple and safe . In most cases, after puncture and aspiration, the cystic cavity is flushed with metronidazole and then injected with antimicrobial agent to preserve it. α chymotrypsin and dexamethasone are applied to dissolve fibrin, promote the inflammatory reaction to subside and recanalize the fallopian tube, and thin the mucous pus, which is conducive to Re-puncture aspiration is possible, but there is a possibility of re-fluidization. To solve this problem, 95% ethanol can also be injected into the cystic lumen to harden the cystic wall for the purpose of treatment and to reduce recurrence, especially before IVF-ET where this method of treatment is ideal. In recent years, many clinicians have started to try a simple and convenient method of tubal obstruction, namely the hysteroscopic placement of the Essure device, which was approved for clinical use by the FDA in 2002. The placement of Essure is usually performed with the help of an outpatient hysteroscope, and the entire procedure lasts 5-8 min and can be left for 30-60 min of postoperative observation. At 3 months postoperatively, HSG is feasible to view the results of tubal obstruction. Although Essure’s study achieved satisfactory results, there are still problems of small sample size and lack of prospective randomized controlled studies. Therefore, it is currently under further observation in clinical practice. Surgical treatment of severe tubal effusion is poor and mostly IVF treatment is used. However, previous studies have shown a decrease in clinical pregnancy and embryo implantation rates and an increase in unintended pregnancy and miscarriage rates in patients with hydrocele, and in 2012, the Executive Committee of the American Society for Reproductive Medicine published recommendations that hydrocele tubectomy or proximal block prior to IVF may improve clinical outcomes in patients with hydrocele. Currently, the main approaches are resection of the hydrosalpinx, proximal tubal ligation or blockage, and ultrasound-guided aspiration of the hydrosalpinx. Several prospective, randomized, controlled clinical studies have shown that removal of the hydrocele-bearing fallopian tube increases the clinical pregnancy and live birth rates in INF. However, some studies have found that tubal resection may affect the blood supply to the ovaries, causing a decrease in ovarian reserve function, as evidenced by decreased blood flow to the ovary on the side of the removed tube and a decrease in the number of sinus follicles. When removing the fallopian tubes, the tubes should be removed as close to the fallopian tubes as possible to protect the vessels of the fallopian tube tract and reduce the impact on the blood supply to the ovaries. For the management of hydrosalpinx before IVF, ligation of the proximal fallopian tube has also achieved the same results as tubectomy, which can be accomplished with either laparoscopic bipolar electrocoagulation or mechanical clamping of the fallopian tube. Although, current reports show that proximal tubal block can improve the clinical outcome of IVF in patients with hydrosalpinx; however, there is a possibility that the hydrosalpinx may worsen after proximal obstruction, and even if the hydrosalpinx is released through perforation, recurrence is still possible after surgery. In addition, there are Chinese herbal medicine treatment and combined Chinese and Western medicine treatment. To solve the problem of pregnancy in women of reproductive age with hydrosalpinx, the idea of treating hydrosalpinx should be combined with the patient’s age, duration of infertility, ovarian reserve function, degree of hydrosalpinx, and socioeconomic conditions. And age and ovarian reserve capacity are the main factors that must be considered.