title: Proximal occlusion of hydrosalpinx by hysteroscopic placement of microinsert before in vitro fertilization-embryo transfer.
abstract: OBJECTIVE
  To describe proximal occlusion of a hydrosalpinx by hysteroscopic placement of a microinsert before IVF-ET.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Health maintenance organization and tertiary-care assisted reproductive technology unit.
  
  
  METHODS
  Obese, infertile woman with pelvic adhesive disease and unilateral hydrosalpinx.
  
  
  METHODS
  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.
  
  
  METHODS
  Nonincisional proximal tubal occlusion under local anesthesia and intravenous sedation. Pregnancy by IVF-ET.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Permanente Medical Group, Portland, Oregon.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Rosenfield
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Stones
authors.forename: Alison
authors.initials: A
authors.lastname: Coates
authors.forename: Robert K
authors.initials: RK
authors.lastname: Matteri
authors.forename: John S
authors.initials: JS
authors.lastname: Hesla
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000009:adverse effects*; D005187:Fallopian Tubes / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects* / Q000379:methods; D010535:Laparoscopy / Q000379:methods; D050498:Live Birth