Microinsert Placement Research Articles

Proximal occlusion of hydrosalpinx by hysteroscopic placement of microinsert before in vitro fertilization–embryo transfer

To describe proximal occlusion of a hydrosalpinx by hysteroscopic placement of a microinsert before IVF-ET. Case report. Health maintenance organization and tertiary-care assisted reproductive technology unit. Obese, infertile woman with pelvic adhesive disease and unilateral hydrosalpinx. Hysteroscopic placement of a microinsert into the proximal segment of a fallopian tube that was distally obstructed by hydrosalpinx. No intraoperative or postoperative complications occurred with hysteroscopic placement of microinsert. Nonincisional proximal tubal occlusion under local anesthesia and intravenous sedation. Pregnancy by IVF-ET. No intraoperative or postoperative complications with hysteroscopic placement of microinsert were seen. After uterine transfer of three embryos, dichorionic-diamniotic twins were delivered by cesarean section at 34 weeks of gestation. Hysteroscopic placement of a microinsert to proximally occlude a hydrosalpinx might be an alternative to laparoscopic proximal tubal occlusion or salpingectomy in patients with tubal disease planning IVF-ET.

Ultrasound: An effective method for localization of the echogenic Essure sterilization micro-insert: Correlation with radiologic evaluations

To examine the reliability and practicality of performing office-based transvaginal ultrasound for determining the ease of locating the Essure hysteroscopic sterilization micro-insert and compare its usefulness against established radiologic evaluations. Prospective single-center, single-arm, clinical study (Canadian Task Force classification xx). Hospital-based clinical research center. One hundred forty-five women of reproductive age and proven fertility. Thirty-seven women who underwent the Essure hysteroscopic method of sterilization had routine radiologic and transvaginal ultrasound assessments for determining the retention of these micro-inserts from 3 months to 2 years after placement. An additional 108 women had ultrasound assessment as the only means of micro-insert localization 3 months after placement. The 145 women (100%) who underwent an ultrasound assessment at a 3-month, posthysteroscopic-sterilization office visit had their micro-inserts readily identified and localized to the uterotubal area due to the micro-inserts' dense echogenic properties. For the 37 women who had both assessments, the ultrasound findings correlated with pelvic radiograph and hysterosalpingogram assessments of micro-insert location in all instances. In addition, the ultrasound evaluations provided additional information about the micro-inserts relative position to the surrounding, less-echogenic soft tissue structures of the upper uterotubal area. In the 37 women who had serial ultrasound and radiologic evaluations performed for up to 2 years after micro-insert placement, ultrasound was found to be equally effective in identifying the location of the micro-inserts and indicted that their position remained identifiable and stable over time. A single transvaginal ultrasound in-office examination, performed 3 months after hysteroscopic micro-insert placement, was found to be a simple, reliable, and convenient method of assessing micro-insert location, when compared with radiologic assessments.

Proximal occlusion of hydrosalpinx by hysteroscopic placement of microinsert before in vitro fertilization-embryo transfer

Proximal occlusion of hydrosalpinx by hysteroscopic placement of microinsert before in vitro fertilization-embryo transfer

Essure Hysteroscopic Sterilization: Results Based on Utilizing a New Coil Catheter Delivery System

Study Objective To assess the safety and placement effectiveness of a new delivery catheter for the Essure micro-insert hysteroscopic sterilization system. Design Prospective, multicenter, single-arm clinical study. (Canadian Task Force classification II-3). Setting Hospital-based clinical research centers. Patients One hundred two women of reproductive age and proven fertility. Intervention A new coil catheter delivery system was used for micro-insert placement. Measurements and Main Results The bilateral placement of micro-inserts using the coil catheter delivery system occurred in 100 women out of 102 attempts (98%). The two women who did not have successful micro-insert placement were subsequently shown to have proximal tubal stenotic disease. Conclusion These findings indicate that the introduction of the coil catheter delivery system for Essure hysteroscopic sterilization improves the micro-insert bilateral placement rate when compared with previous studies. It is hypothesized that the coil catheter has superior navigational properties, particularly within tortuous or narrowed tubal lumens.

Hysteroscopic placement of the essure micro-insert for permanent birth control in an office-based setting

Hysteroscopic placement of the essure micro-insert for permanent birth control in an office-based setting