Essure^庐 hydrosalpinx occlusion prior to IVF-ET as an alternative to laparoscopic salpingectomy

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• 作者：Velja Mijatovic^a ; ^{mijatovic@vumc.nl} ; Kim Dreyer^a ; Mark Hans Emanuel^b ; Roel Schats^a ; Peter G.A. Hompes^a
• 关键词：Essure hysteroscopic tubal occlusion ; Hydrosalpinges ; IVF-ET
• 刊名：European Journal of Obstetrics and Gynecology and Reproductive Biology
• 出版年：2012
• 期刊代码：92_03012115
• 类别：med
• 出版时间：March, 2012
• 卷：161
• 期：1
• 页码：42-45
• 文件大小：155 K

摘要

Objective

To investigate the success rate of proximal tubal occlusion with Essure^庐 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.

Study design

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.

Result(s)

In all patients the Essure^庐 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.

Conclusion(s)

Essure^庐 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.