Essure a novel option for the treatment of hydrosalpinx: a case series and literature review

Abstract

Objective: The aim of this study is to evaluate the use of hysteroscopic Essure device placement for the treatment of hydrosalpinx (HS)-related infertility in patients with laparoscopic contraindications and compared their pregnancy outcomes following IVF–ICSI treatment with those patients having had laparoscopic tubal occlusion (LTO).

Patients: From 2008 to 2014 a total of 50 patients were diagnosed with unilateral or bilateral hydrosalpinges: 29 patients had laparoscopic contraindications and were treated hysteroscopically and 21 patients were treated with laparoscopical salpingectomy.

Results: Of the 29 patients who underwent treatment with Essure®, 21 began a cycle of in vitro fertilization (IVF), and 13 finished in embryo transfer that resulted in seven clinical pregnancies. Furthermore, in the group of women treated with salpingectomy, 17 started an IVF cycle that resulted in 12 clinical pregnancies. The clinical pregnancy rate per patient with an IVF cycle started was 33.3% and 70.6%, the live-birth rate per patient was 14.3% and 52.9%, the miscarriage rate was 57.1% and 18.2%, and the implantation rate was 16.3% and 34.1% for hysteroscopy and laparoscopy, respectively.

Conclusion: Essure® placement is an alternative method for occlusion of hydrosalpinges before IVF. Monitoring the live-birth rate confirms that this option may be considered when laparoscopy is impossible or contraindicated.

Chinese abstract

目的：本研究目的是评估宫腔镜下输卵管近端栓塞治疗存在腹腔镜禁忌的输卵管积水(HS)性不孕并比较其与腹腔镜下输卵管阻塞术(LTO)后患者行IVF–ICSI的妊娠结局。

患者：自2008年至2014年共有50名患者确诊为单侧或双侧输卵管积水：29名患者存在腹腔镜禁忌证并通过宫腔镜治疗，21名患者经腹腔镜输卵管切除术治疗。

结果：29名经宫腔镜下输卵管近端栓塞治疗的患者中，21名开始一个周期的IVF，13名完成胚胎移植并有7名临床妊娠。此外，经腹腔镜输卵管切除术患者中，17名开始IVF周期并有12名临床妊娠。宫腔镜和腹腔镜术后接受IVF患者的临床妊娠率分别为33.3%和70.6%，活产率分别为14.3% 和52.9%，流产率分别为57.1%和18.2%，着床率分别为16.3%和34.1%。

结论：宫腔镜下输卵管近端栓塞是输卵管积水在IVF前行输卵管阻塞术的一种替代方法。出生率监测证实可在腹腔镜手术不可能或存在禁忌证时选择此方法。

• Assisted reproductive technology
• Essure
• hydrosalpinx
• infertility
• live-birth rate

Declaration of interest

The authors report no conflicts of interest. Additionally, the authors have no commercial, proprietary or financial interest in the products or companies described in this article.

Funding was not required for this study.

The study was performed in a regular practice basis and all the subjects demonstrated comprehension after the explanation of the procedure and signed a written consent.

IRB Reina Sofia University Hospital. January 2008.