1. On the one hand, as a long-term accumulation of abnormal body fluid near the ovary, hydrocele can compress the ovarian vessels, reduce the ovarian school supply, release toxins and various inflammatory cytokines, and affect ovarian function and its responsiveness to hormones in COH. On the other hand, most patients with hydrocele have chronic pelvic infections and severe pelvic adhesions. The encapsulated tubal hydrocele has a mechanical hindering effect on the growth and volume increase of eggs after ovarian stimulation, and the extensive hydrocele can cause difficulties in egg retrieval surgery, which can easily mispenetrate and contaminate, affecting egg retrieval. 2. Effect of effusion on endometrial tolerance: Infection causes effusion to return to the uterine cavity, causing the release of cytokines, prostate, and other inflammatory complexes of leukocyte chemotactic factors from the tissue, which act on the endometrium directly or through blood and lymphatic transit, potentially affecting the expression of factors related to endometrial implantation, thus reducing the endometrial tolerance to embryos and affecting embryo implantation. The effect of hydrocele on embryonic development: Whether hydrocele has toxic effects on embryonic development is still controversial, and some scholars believe that microorganisms, lymphocytes and cytokines in hydrocele may have damaging effects on embryos. 4. Mechanical interference with endometrium-embryo interaction: The fluid in the fallopian tube may backflow into the uterine cavity and flush the embryo, which may cause early embryo loss. At the same time, the fluid on the endometrial surface may interfere with the interaction between the endometrium and the embryo, leading to failure of implantation. During treatment, the management of hydrocele includes anti-inflammatory, transvaginal aspiration of hydrocele, laparoscopic clamping of the fallopian tube with hydrocele and stoma, and tubectomy. If preoperative examination reveals one or both
For patients with mild to moderate hydrosalpinx, ultrasound monitoring can be performed to monitor closely the flow of hydrosalpinx into the uterine cavity, and tubal aspiration can be performed according to the patient’s specific condition. However, tubal puncture can only minimize the possibility of a large collection of fluid in the fallopian tubes and its return to the uterine cavity, but the risk of recurrence of fluid after puncture and the risk of return to the human uterine cavity; as well as the risk of bleeding, infection, and damage to other organs of the pelvis, by puncture itself. In addition, the success rate of patients with hydrosalpinx without treatment decreases by 30% miscarriage rate and the incidence of ectopic pregnancy increases, during the monitoring process, if there is a significant uterine fluid and suspicion of hydrosalpinx due to reflux, it is recommended to cancel the embryo transfer, freeze the embryo, and deal with it after the elective FET.