Utilization of the Essure ® micro-insert for the treatment of hydrosalpinx prior to in vitro fertilization

Abstract

ObjectiveTo evaluate the success rate of proximal tubal occlusion with placement of Essure® micro-inserts in women with hydrosalpinx (HS) prior to undergoing in vitro fertilization (IVF), and to observe pregnancy rates post-IVF.DesignProspective, non-randomized, off-label, observational study of micro-insert tubal occlusion in women with HS and subsequent pregnancy rates following IVF using fresh or frozen embryos.Materials and methodsPlacement of Essure micro-inserts followed by a hysterosalpingogram (HSG) 3 months post-procedure, and IVF in 7 women ages 32–44 presenting with infertility and unilateral or bilateral HS as determined by laparoscopy or HSG.ResultsBilateral micro-insert placement was performed in 5 women, unilateral in 1 woman (with a unilateral HS), and 1 unsuccessful placement attempt. The devices were intentionally placed with an average of 2–3 trailing coils visible post-procedure. Follow-up HSG has been completed in 4 patients, with all demonstrating tubal occlusion. One woman elected to not have an HSG, and 1 patient is awaiting her HSG. IVF treatment was initiated in all patients an average of 3.5 months post-confirmation of tubal occlusion. Three women became pregnant on their first IVF cycle with term deliveries, one is currently 3 months pregnant from a frozen embryo cycle, one did not achieve pregnancy and one is awaiting her follow-up HSG prior to beginning IVF. There have been no complications from Essure placement or from the devices remaining in place during pregnancy.ConclusionsPreliminary results demonstrate an excellent pregnancy rate with IVF following Essure micro-insert placement for HS. ObjectiveTo evaluate the success rate of proximal tubal occlusion with placement of Essure® micro-inserts in women with hydrosalpinx (HS) prior to undergoing in vitro fertilization (IVF), and to observe pregnancy rates post-IVF. To evaluate the success rate of proximal tubal occlusion with placement of Essure® micro-inserts in women with hydrosalpinx (HS) prior to undergoing in vitro fertilization (IVF), and to observe pregnancy rates post-IVF. DesignProspective, non-randomized, off-label, observational study of micro-insert tubal occlusion in women with HS and subsequent pregnancy rates following IVF using fresh or frozen embryos. Prospective, non-randomized, off-label, observational study of micro-insert tubal occlusion in women with HS and subsequent pregnancy rates following IVF using fresh or frozen embryos. Materials and methodsPlacement of Essure micro-inserts followed by a hysterosalpingogram (HSG) 3 months post-procedure, and IVF in 7 women ages 32–44 presenting with infertility and unilateral or bilateral HS as determined by laparoscopy or HSG. Placement of Essure micro-inserts followed by a hysterosalpingogram (HSG) 3 months post-procedure, and IVF in 7 women ages 32–44 presenting with infertility and unilateral or bilateral HS as determined by laparoscopy or HSG. ResultsBilateral micro-insert placement was performed in 5 women, unilateral in 1 woman (with a unilateral HS), and 1 unsuccessful placement attempt. The devices were intentionally placed with an average of 2–3 trailing coils visible post-procedure. Follow-up HSG has been completed in 4 patients, with all demonstrating tubal occlusion. One woman elected to not have an HSG, and 1 patient is awaiting her HSG. IVF treatment was initiated in all patients an average of 3.5 months post-confirmation of tubal occlusion. Three women became pregnant on their first IVF cycle with term deliveries, one is currently 3 months pregnant from a frozen embryo cycle, one did not achieve pregnancy and one is awaiting her follow-up HSG prior to beginning IVF. There have been no complications from Essure placement or from the devices remaining in place during pregnancy. Bilateral micro-insert placement was performed in 5 women, unilateral in 1 woman (with a unilateral HS), and 1 unsuccessful placement attempt. The devices were intentionally placed with an average of 2–3 trailing coils visible post-procedure. Follow-up HSG has been completed in 4 patients, with all demonstrating tubal occlusion. One woman elected to not have an HSG, and 1 patient is awaiting her HSG. IVF treatment was initiated in all patients an average of 3.5 months post-confirmation of tubal occlusion. Three women became pregnant on their first IVF cycle with term deliveries, one is currently 3 months pregnant from a frozen embryo cycle, one did not achieve pregnancy and one is awaiting her follow-up HSG prior to beginning IVF. There have been no complications from Essure placement or from the devices remaining in place during pregnancy. ConclusionsPreliminary results demonstrate an excellent pregnancy rate with IVF following Essure micro-insert placement for HS. Preliminary results demonstrate an excellent pregnancy rate with IVF following Essure micro-insert placement for HS.