Essure® hydrosalpinx occlusion prior to IVF-ET as an alternative to laparoscopic salpingectomy.
OBJECTIVE
To investigate the success rate of proximal tubal occlusion with Essure(®) devices in subfertile women with unilateral or bilateral hydrosalpinx and to observe the results of subsequent treatment with IVF-ET and/or frozen embryo transfer.


METHODS
Prospective, single-arm, clinical study in 20 women with unilateral or bilateral hydrosalpinges (all visible on transvaginal ultrasound) due to undergo IVF-ET and/or frozen embryo transfer. In all patients, laparoscopy was considered to be contraindicated due to extensive pelvic adhesions.


RESULTS
In all patients the Essure(®) devices were placed in an ambulant setting without any complications. Proximal tubal occlusion was confirmed by hysterosalpingography in 19 out of 20 patients (95%) and in 26 of 27 treated tubes (96%). After 45 embryo transfer procedures in 19 patients, 18 pregnancies with 12 live births, 6 miscarriages and 1 immature delivery (probably related to cervical insufficiency leading to chorioamnionitis and subsequent rupture of the membranes) were observed.


CONCLUSIONS
Essure(®) devices are effective in inducing proximal tubal occlusion in subfertile patients with hydrosalpinges. After artificial reproductive treatments a cumulative live birth rate per patient of 63% and a cumulative live birth rate per transfer of 27% were achieved. The latter was related to the large proportion of patients with severe endometriosis.
VU University Medical Center, Department of Reproductive Medicine, Amsterdam, The Netherlands. mijatovic@vumc.nl
Velja
V
Mijatovic
Kim
K
Dreyer
Mark Hans
MH
Emanuel
Roel
R
Schats
Peter G A
PG
Hompes
D000328:Adult; D000075202:Contraindications; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D058994:Salpingectomy; D013246:Sterilization, Tubal / Q000295:instrumentation / Q000379:methods*