Essure treatment of hydrosalpinges.

Abstract:

OBJECTIVE:To describe the use of Essure microinsert placement in patients with hydrosalpinges before IVF. DESIGN:Retrospective case-series. SETTING:An advanced endoscopic practice within a university-affiliated teaching hospital. PATIENT(S):Five women with unilateral or bilateral hydrosalpinges on transvaginal ultrasound, laparoscopy, or hysterosalpingogram who were planning further fertility therapy. In all patients, laparoscopy was felt to be relatively contraindicated because of previous extensive abdominopelvic surgery. INTERVENTION(S):Hysteroscopic placement of the Essure microinsert in four patients under general anesthesia. One patient underwent fluoroscopically guided placement. MAIN OUTCOME MEASURE(S):Placement rates and postoperative recovery, technical challenges in Essure placement, and results of subsequent treatment with IVF when available. RESULT(S):Successful bilateral Essure placement was confirmed in two of five patients. Unilateral placement was achieved in two of five. There were no postoperative complications. No pregnancies have occurred thus far. CONCLUSION(S):Hysteroscopic placement of the Essure microinsert is a minimally invasive option for proximal tubal occlusion. In patients requiring occlusion of hydrosalpinges before IVF and with contraindications to abdominal surgery, this technique may offer a safer alternative. Preoperative documentation of proximal tubal patency helps predict placement success. Further research into this unique clinical scenario is required.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Hitkari JA,Singh SS,Shapiro HM,Leyland N

doi

10.1016/j.fertnstert.2007.01.050

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

1663-6

issue

6

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(07)00208-7

journal_volume

88

pub_type

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