The Prevalence of Histologically Confirmed Endometriosis in Salpingectomy Specimens for Hydrosalpinx and Subsequent Reproductive Outcomes Publisher

Summary: Can blocked fallopian tubes conceal endometriosis? Tissue tests found hidden disease and suggested poorer fertility outcomes; more research is needed. #Endometriosis #Fertility

Davari Tanha F ; Mehri S ; Akbari R ; Salehi F ; Mohammadkhani R ; Sinaeifar Z ; Behzadi A M
Source: Obstetrics and Gynecology International Published:2026

Abstract

Background: Hydrosalpinx, a fluid-filled blocked fallopian tube, is a major cause of infertility and is mainly linked to pelvic inflammatory disease. However, its connection to endometriosis, especially hidden tubal endometriosis without visible signs, is not well studied. This research aimed to find the prevalence of confirmed endometriosis in salpingectomy samples removed due to hydrosalpinx and to evaluate the subsequent reproductive outcomes. Methods: A cross-sectional study involved 70 infertile women undergoing laparoscopic salpingectomy at a specialized center. We gathered demographic, surgical, and pathological information from medical records. The main outcome was the occurrence of endometriosis based on histopathology. The secondary outcome was the rate of clinical pregnancies (either spontaneous or through ART) after salpingectomy. We used SPSS v23.0 for statistical analysis, considering p < 0.05 as significant. Results: The average age of participants was 37.38 ± 6.13 years. Clear histological evidence of endometriosis was found in 14.3% (10/70) of samples. Notably, 8% (4/50) of patients without a history of endometriosis had hidden tubal disease. The visual detection of endometriosis during laparoscopy was marginally significantly associated with a positive pathology (37.5% vs. 7.4%, p = 0.050). After salpingectomy, the total clinical pregnancy rate was 25.5% (12/47). However, none of the patients (0%) with a diagnosis of tubal endometriosis achieved pregnancy, while those with other pathologies had a 30% success rate. Conclusion: Examining salpingectomy samples is essential for detecting endometriosis. Women with histologically confirmed tubal endometriosis may represent a subgroup with potentially poorer reproductive outcomes. However, this observation is exploratory and requires validation in larger studies with adequate adjustment for age, ovarian reserve, and ART-related factors. Copyright © 2026 Fatemeh Davari-Tanha et al. Obstetrics and Gynecology International published by John Wiley & Sons Ltd.