The imaging film suggests a large bilateral hydrocele in the fallopian tubes, and even the ultrasound can detect tortuous tubular dark areas in the adnexal region or separate fluid sacs, the patient intends to do IVF but does not know what to do next. If everything is normal, the patient can choose to have her tubes ligated first and then undergo IVF if she is financially able to do so. Patients who cannot accept tubal ligation can also try IVF once and consider surgery if they are unsuccessful in repeated transplants. For patients with low ovarian function, for high success rate, egg retrieval and whole blastocyst freezing can be considered before surgical treatment for tubal ligation and post-operative blastocyst transfer. For patients who choose to undergo surgery before IVF, the couple should also be repeatedly informed of the irreversibility of tubal ligation. It is not uncommon to see a simple tubal cystostomy followed by recurrence and formation of hydrocele two or three months later. For patients with bilateral hydrosalpinx who are financially eligible and have normal ovarian function, ligation of both tubes before IVF can reduce the effect of hydrosalpinx on embryo transfer, improve pregnancy rate, and reduce the risk of embryonic abortion and ectopic pregnancy.