Essure hydrosalpinx occlusion prior to IVF-ET/ frozen embryo transfer in patients with a contraindication for laparoscopy

Abstract

ObjectiveTo investigate the success rate of proximal tubal occlusion with Essure devices in subfertile women with uni-or bilateral hydrosalpinx and to observe the results of subsequent treatment with IVF-ET and/or frozen embryo transfer.DesignProspective, single-arm, clinical study.Materials and MethodsTwenty women with unilateral or bilateral hydrosalpinges (all visible on transvaginal ultrasound) due to undergo IVF-ET and/or frozen embryo transfer were hysteroscopically treated with placement of Essure devices. In all patients, laparoscopy was considered to be contraindicated due to extensive pelvic adhesions.Main Outcome Measure(s): Successful proximal tubal occlusion and reproductive/ obstetrical outcomes after artificial reproductive treatments (ART).ResultsIn all patients the Essure devices were placed in an ambulant setting without any complications. Proximal tubal occlusion was confirmed by HSG in 19 out of 20 patients. After 45 ART cycles in 19 patients, 18 pregnancies (1 twin) with 12 life births, 6 miscarriages and 1 immature delivery (which was related to cervical insufficiency and not to the Essure devices) were observed.ConclusionEssure devices are effective in inducing proximal tubal occlusion in subfertile patients with hydrosalpinges. After ART, excellent reproductive and obstetrical outcomes were found in this largest case-series on this topic. ObjectiveTo investigate the success rate of proximal tubal occlusion with Essure devices in subfertile women with uni-or bilateral hydrosalpinx and to observe the results of subsequent treatment with IVF-ET and/or frozen embryo transfer. To investigate the success rate of proximal tubal occlusion with Essure devices in subfertile women with uni-or bilateral hydrosalpinx and to observe the results of subsequent treatment with IVF-ET and/or frozen embryo transfer. DesignProspective, single-arm, clinical study. Prospective, single-arm, clinical study. Materials and MethodsTwenty women with unilateral or bilateral hydrosalpinges (all visible on transvaginal ultrasound) due to undergo IVF-ET and/or frozen embryo transfer were hysteroscopically treated with placement of Essure devices. In all patients, laparoscopy was considered to be contraindicated due to extensive pelvic adhesions.Main Outcome Measure(s): Successful proximal tubal occlusion and reproductive/ obstetrical outcomes after artificial reproductive treatments (ART). Twenty women with unilateral or bilateral hydrosalpinges (all visible on transvaginal ultrasound) due to undergo IVF-ET and/or frozen embryo transfer were hysteroscopically treated with placement of Essure devices. In all patients, laparoscopy was considered to be contraindicated due to extensive pelvic adhesions. Main Outcome Measure(s): Successful proximal tubal occlusion and reproductive/ obstetrical outcomes after artificial reproductive treatments (ART). ResultsIn all patients the Essure devices were placed in an ambulant setting without any complications. Proximal tubal occlusion was confirmed by HSG in 19 out of 20 patients. After 45 ART cycles in 19 patients, 18 pregnancies (1 twin) with 12 life births, 6 miscarriages and 1 immature delivery (which was related to cervical insufficiency and not to the Essure devices) were observed. In all patients the Essure devices were placed in an ambulant setting without any complications. Proximal tubal occlusion was confirmed by HSG in 19 out of 20 patients. After 45 ART cycles in 19 patients, 18 pregnancies (1 twin) with 12 life births, 6 miscarriages and 1 immature delivery (which was related to cervical insufficiency and not to the Essure devices) were observed. ConclusionEssure devices are effective in inducing proximal tubal occlusion in subfertile patients with hydrosalpinges. After ART, excellent reproductive and obstetrical outcomes were found in this largest case-series on this topic. Essure devices are effective in inducing proximal tubal occlusion in subfertile patients with hydrosalpinges. After ART, excellent reproductive and obstetrical outcomes were found in this largest case-series on this topic.