How reliable is hydrosalpinx detection on transvaginal scan?

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Hydrosalpinx means that fluid has collected inside one or both fallopian tubes. This usually happens because of a past infection or inflammation. However, it is important to know that a transvaginal ultrasound (TVS) (an internal ultrasound done through the vagina to view the uterus and ovaries), although helpful, is not always 100% accurate in diagnosing this condition. Sometimes, what looks like a hydrosalpinx on the scan may actually be an ovarian cyst (a fluid-filled sac on the ovary), a folded fallopian tube, or a harmless pocket of fluid, especially if the scan was not done during your period or if the visibility was limited.

Since you have never been sexually active, the chances of a true hydrosalpinx are lower, because most cases are caused by pelvic infections that spread through sexual contact. The usual next step is to repeat the scan after your next period or consider a pelvic MRI (a detailed imaging test that shows soft tissues clearly) to confirm the findings.

For fertility assessment, your doctor may also recommend a hysterosalpingography (HSG) (an X-ray test where dye is put inside the uterus to check if the tubes are open) or a saline sonography (an ultrasound done after filling the uterus with saline water to get a clearer view) later on if you plan to conceive in the future.

For now, please do not panic. False positives are fairly common, and a repeat scan will give much clearer results.

I hope this helps you.

Kindly revert if there are any queries.

Thank you.