Proximal occlusion of hydrosalpinges by Essure® before assisted reproduction techniques: a French survey

ObjectivesTo study the feasibility and results (live-birth and complication rates) of placement of Essure® microinserts before assisted reproductive technology (ART) treatment of women with hydrosalpinx when laparoscopy should be avoided.Study design National survey of 45 French hospital centres providing ART reporting a retrospective analysis of 43 women with unilateral or bilateral hydrosalpinges and Essure® placement. The results of the following ART cycle were studied for 54 embryo transfers.ResultsThe placement success rate reached 92.8% (65/70 tubes), and the mean number of visible intrauterine coils was 1.61 (range: 0-6). Pyosalpinx occurred in one case, and expulsion of the device into the uterus in two others. Of 43 women, 29 (67.4%) had a total of 54 fresh or frozen embryos transferred. The clinical pregnancy rate was 40.7% (22/54) and the live-birth rate 25.9% (14/54). The implantation rate was 29.3% (27/92).ConclusionEssure® placement is an effective method for occlusion of hydrosalpinges before IVF. Monitoring the live-birth rate confirms that this option is the strongest in cases when laparoscopy is impossible or contraindicated.