New clinic found fluid in one of my tubes and wants it removed before we transfer our last embryo. Has anyone had a hydrosalpinx taken out?

Some of you will remember I was deciding about moving clinics. We moved. The new clinic did a full set of tests before agreeing to transfer our frozen embryo, including a HyCoSy, which the old clinic never did.

It showed a hydrosalpinx on the left. A blocked tube full of fluid. The consultant wants to remove the tube by keyhole surgery before we transfer, because she says the fluid can make implantation less likely.

My first reaction was fury. Two fresh cycles, two transfers, and nobody looked? My second reaction was fear, because it's surgery, and I'm 42 now and every month feels like it counts. My third reaction is that I don't really understand why a tube matters if IVF doesn't use them.

I'd be furious too. For what it's worth, getting a straight answer from the new place sounds like exactly what you moved for.

My cousin had this. Keyhole, home the same day, sore for a week. She said the worst part was the gas pain in her shoulder afterwards, which nobody warned her about.

Mrs Okafor said:

I don't really understand why a tube matters if IVF doesn't use them

It's a very fair question. IVF doesn't need the tubes, that's true, but a hydrosalpinx is the one kind of tubal problem that can still affect it. The tube is blocked at its far end and fills with fluid, and that fluid can drain back into the womb, where it is thought to make it harder for an embryo to implant. That's why many clinics recommend dealing with it before a transfer.

The evidence here is reasonably good. A Cochrane review of the trials found that removing the affected tube by laparoscopy, or blocking it off where it joins the womb, before IVF increased the odds of pregnancy compared with doing nothing. The trials didn't report live births, so the size of the benefit for a baby at the end is less certain, but the direction is consistent, and it's the reason your consultant is recommending it. Occlusion rather than removal is sometimes chosen when surgery would be more difficult, and that's a reasonable thing to ask her about.

On the timing worry, it's worth asking her directly how long she would want you to wait between the surgery and the transfer, and how that fits with your age and your frozen embryo, which isn't ageing in the freezer. Emma has written up how the tubes are checked in fertility tests and investigations. Whether surgery is right in your case is a decision for you and your consultant, who has your scans.

"The embryo isn't ageing in the freezer" is the sentence I needed, thank you. Asked the consultant all of it. She'd do it next month and transfer the cycle after, so about two months' delay. She also said that the fluid might not have been there at the earlier cycles, so I'm letting go of the fury a bit. Surgery is booked.

Thinking of you, and fully in favour of the new clinic already.

Done on Monday. Home the same evening. Gemma's cousin was right about the shoulder, I was not warned either. Sore but walking about. The consultant said it was "very swollen" and she was glad it was out, which helped more than I expected. Transfer pencilled for December.