Molecular Mechanisms and Precision Surgery for Hydrosalpinx-induced Reproductive Dysfunction

Abstract Hydrosalpinx is a significant factor influencing female fertility, yet the mechanisms by which it affects ovarian function remain incompletely understood. This study systematically evaluated the effects of hydrosalpinx on reproductive outcomes and explored the underlying molecular mechanisms involved. Following PRISMA guidelines, we conducted a systematic review and meta-analysis of 144 studies published between 2010 and 2025, including randomized controlled trials and clinical studies focusing on hydrosalpinx and reproductive outcomes. The findings revealed that hydrosalpinx negatively impacts female reproductive potential by inducing complex inflammatory responses and oxidative stress pathways, ultimately reducing success rates in assisted reproductive technology (ART). Surgical treatment of hydrosalpinx significantly contributes to reconstructing the reproductive micro-environment and enhancing ovarian function. Key results indicate that effective reconstruction of the reproductive micro-environment fosters follicular development and improves oocyte quality, while personalized intervention strategies boost in vitro fertilization (IVF) success rates. Furthermore, immune cell regulatory networks play pivotal roles in determining reproductive outcomes. In conclusion, a thorough understanding of how hydrosalpinx influences the reproductive micro-environment is crucial for developing targeted medical interventions to optimize fertility outcomes.