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

Autor: Lorente González J; a Department of Obstetrics and Gynecology , ''Reina Sofia'' University Hospital , Cordoba , Spain and., Ríos Castillo JE; a Department of Obstetrics and Gynecology , ''Reina Sofia'' University Hospital , Cordoba , Spain and., Pomares Toro E; a Department of Obstetrics and Gynecology , ''Reina Sofia'' University Hospital , Cordoba , Spain and., Romero Nieto MI; a Department of Obstetrics and Gynecology , ''Reina Sofia'' University Hospital , Cordoba , Spain and., Castelo-Branco C; b Faculty of Medicine , Institut Clinic of Gynecology, Obstetrics and Neonatology, University of Barcelona, Hospital Clinic-Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) , Barcelona , Spain., Arjona Berral JE; a Department of Obstetrics and Gynecology , ''Reina Sofia'' University Hospital , Cordoba , Spain and.
Jazyk: angličtina
Zdroj: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology [Gynecol Endocrinol] 2016; Vol. 32 (2), pp. 166-70. Date of Electronic Publication: 2015 Oct 29.
DOI: 10.3109/09513590.2015.1103221
Abstrakt: 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.
Databáze: MEDLINE
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