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

Abstract

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.

High miscarriage rate in women treated with Essure® for hydrosalpinx before embryo transfer: a systematic review and meta‐analysis

“…The other four studies were included in our analysis. Moreover, we included four additional studies that were not considered in that review. The miscarriage rate reported in the previous review (25.9%) is lower than that of our study (38%).…”

“…Twenty‐six studies assessing the treatment of hydrosalpinx in women undergoing ET were included in our analysis. There were eight studies evaluating Essure; none of them was a randomized or even a prospective observational trial, and five evaluated only women who had a contraindication for laparoscopy. Overall, we observed that insertion of Essure prior to ET in women with hydrosalpinx is associated with a higher rate of miscarriage in comparison with other methods of treatment, without an improvement in clinical‐pregnancy or live‐birth rates.…”

“…Therefore, 26 studies (from 32 records) were considered eligible. There were four studies with two registers each: Berkkanoglu et al , Cenksoy et al , Galen et al , Matorras et al ; one study with three registers: Mijatovic et al ; and 21 studies with one register each. Data from one study regarding pregnancy outcomes in women with Essure undergoing IVF were also presented in a study reporting on all pregnancies in women with Essure in the same country; we avoided including redundant data in our quantitative analyses.…”

“…We tried to contact authors from all studies: additional details were provided for six studies; the authors of three studies confirmed all the extracted data. Four studies were published as abstracts only and the remaining 22 studies were published as full articles.…”

Effect comparison of salpingectomy versus proximal tubal occlusion on ovarian reserve

“…[ 2 ] The current treatment options for hydrosalpinx mainly includes: salpingectomy, tubal proximal ligation, transvaginal aspirationat and salpingostomy, but only laparoscopic salpingectomy and tubal occlusion has proven to be effective to improve the outcome of IVF. [ 3 ] Currently, laparoscopic salpingectomy and tubal occlusion seem to be helpful to improve the success rate of IVF. Reproductive surgery is still necessary as a complementary treatment for optimizing IVF outcomes for patients with not only hydrosalpinges but also select cases of endometriomas and myomas.…”