Essure hysteroscopic tubal occlusion device for the treatment of hydrosalpinx prior to in vitro fertilization-embryo transfer in patients with a contraindication for laparoscopy

Abstract

Objective: To investigate the success rate of proximal tubal occlusion with Essure devices in subfertile women with hydrosalpinges, and to observe the results of subsequent treatment with IVF.

Design: Prospective, single-arm, clinical study.

Setting: University hospital and teaching hospital.

Patient(s): Ten women with uni- or bilateral hydrosalpinges prior to IVF. In all patients laparoscopy was felt to be contraindicated.

Intervention(s): Hysteroscopic placement of Essure devices in an office setting.

Main outcome measure(s): Placement rate, successful proximal tubal occlusion, and pregnancy rate after IVF.

Result(s): All patients had successful placement of the Essure devices without any complications. Proximal tubal occlusion was confirmed by hysterosalpingography in 9 out of 10 patients. A 40% ongoing pregnancy rate was achieved with 20% life births after one IVF cycle and/or frozen embryo transfer.

Conclusion(s): Proximal occlusion of hydrosalpinges with Essure devices before IVF is a successful treatment for patients with a contraindication for salpingectomy.