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Fouda UM, Elshaer HS, Youssef MA, Darweesh FF. Extended doxycycline treatment versus salpingectomy in the management of patients with hydrosalpinx undergoing IVF-ET. J Ovarian Res 2020; 13:69. [PMID: 32532326 PMCID: PMC7293118 DOI: 10.1186/s13048-020-00665-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/24/2020] [Indexed: 11/21/2022] Open
Abstract
Background The aim of this study was to determine whether the treatment with doxycycline before and after oocyte retrieval is as effective as salpingectomy in minimizing the detrimental effect of hydrosalpinx on the outcomes of IVF-ET. Methods A retrospective analysis was done for the outcomes of the IVF-ET cycles of patients with hydrosalpinx who underwent laparoscopic salpingectomy prior to IVF cycle (n = 260) or were treated with extended doxycycline treatment during the IVF cycle (n = 45). In doxycycline group, doxycycline (100 mg twice daily) was started 1 week before anticipated oocyte retrieval and was continued for 1 week after oocyte retrieval. In salpingectomy group, the mesosalpinx was coagulated as close as possible to the fallopian tube. Results The implantation, clinical pregnancy, ongoing pregnancy and live birth rates were significantly higher in the salpingectomy group (20.87% Vs. 9.91%, P value =0.007, 44.62% Vs. 20%, P value = 0.002, 39.62% Vs. 17.78%, P value = 0.005 and 37.31% Vs. 15.56%, P value = 0.005 respectively). Conclusion Salpingectomy is more effective than extended doxycycline treatment in improving the outcomes of IVF-ET in patients with hydrosalpinx undergoing IVF-ET. Further, larger well designed randomized controlled trials should be conducted to confirm the findings of this study.
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Affiliation(s)
- Usama M Fouda
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Kasr Al-Ainy Hospital, Al-Saraya Street, Cairo, Egypt. .,Riyadh Fertility and Reproductive Health Center, Giza, Egypt.
| | - Hesham S Elshaer
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Kasr Al-Ainy Hospital, Al-Saraya Street, Cairo, Egypt.,Riyadh Fertility and Reproductive Health Center, Giza, Egypt
| | - Mohamed A Youssef
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Kasr Al-Ainy Hospital, Al-Saraya Street, Cairo, Egypt
| | - Fatma F Darweesh
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Kasr Al-Ainy Hospital, Al-Saraya Street, Cairo, Egypt.,Riyadh Fertility and Reproductive Health Center, Giza, Egypt
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2
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Arora R, Shapiro H, Liu K, Arthur R, Cruickshank B, Sharma P, Glass K, Baratz A, Librach C, Greenblatt EM. Safety and Assisted Reproductive Technology Outcomes of Hysteroscopic Tubal Microinserts Versus Laparoscopic Proximal Tubal Occlusion or Salpingectomy for Hydrosalpinges Treatment. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 42:779-786. [PMID: 32224160 DOI: 10.1016/j.jogc.2019.11.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/11/2019] [Accepted: 11/14/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study sought to answer the following question: What are the complications and assisted reproductive technology outcomes among women with hydrosalpinges managed by hysteroscopic microinsert tubal occlusion compared with women with hydrosalpinges managed by laparoscopic proximal tubal occlusion or salpingectomy? METHODS This was a retrospective cohort study conducted from January 2009 to December 2014 at two academic, tertiary care, in vitro fertilization centres in Toronto, Ontario. All patients (n = 52) who underwent hysteroscopic tubal occlusion for hydrosalpinges were identified. Patients who proceeded with embryo transfer cycles after hysteroscopic microinsert (n = 33) were further age matched to a cohort of patients who underwent embryo transfer after laparoscopic proximal tubal occlusion or salpingectomy (n = 33). Main outcome measures were clinical pregnancy rate per patient and per embryo transfer cycle. RESULTS Among 33 patients, there were 39 fresh and 37 frozen embryo transfer cycles in the hysteroscopic group (group A); among 33 patients in the laparoscopic group (group B), there were 42 fresh and 29 frozen embryo transfer cycles. The cumulative clinical pregnancy rate in group A and group B was similar (66.7% vs. 69.7%, respectively; P = 0.8). The clinical pregnancy rate per embryo transfer cycle was also similar in both groups (28.9% in group A vs. 32.4% in group B; P = 0.6). There were two incidents of ectopic pregnancy in the laparoscopic group and no ectopic pregnancy in the hysteroscopic group. There were three major complications: tubo-ovarian abscess, distal migration of the coil after microinsert placement, and an acute abdomen following the hysteroscopic procedure. CONCLUSION Pregnancy outcomes after hysteroscopic placement of a microinsert for hydrosalpinx management before embryo transfer were comparable to those following laparoscopic proximal tubal occlusion or salpingectomy. However, caution is advised regarding microinsert placement for hydrosalpinges before proceeding with assisted reproductive technology.
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Affiliation(s)
- Ritika Arora
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON
| | - Heather Shapiro
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Mount Sinai Hospital, Toronto, ON
| | - Kimberly Liu
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Mount Sinai Hospital, Toronto, ON
| | - Rebecca Arthur
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Mount Sinai Hospital, Toronto, ON
| | - Barbara Cruickshank
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Mount Sinai Hospital, Toronto, ON
| | - Prati Sharma
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; CReATe Fertility Centre, Toronto, ON
| | - Karen Glass
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; CReATe Fertility Centre, Toronto, ON
| | - Ari Baratz
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; CReATe Fertility Centre, Toronto, ON
| | - Clifford Librach
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; CReATe Fertility Centre, Toronto, ON
| | - Ellen M Greenblatt
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Mount Sinai Hospital, Toronto, ON.
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Chen ZQ, Ng EHY, Chen MX, Zhao M, Pan JP, Chen H, Teng XM. Comparison of the ongoing pregnancy rate of in vitro fertilisation following tubal occlusion by microcoil placement versus laparoscopic tubal ligation for hydrosalpinges. HUM FERTIL 2019; 25:86-92. [PMID: 31833424 DOI: 10.1080/14647273.2019.1701204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Zhi Qin Chen
- Center of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ernest Hung Yu Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Miao Xin Chen
- Center of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Mei Zhao
- Center of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jia Ping Pan
- Center of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hong Chen
- Center of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiao Ming Teng
- Center of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
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Cai HL, Pan LY, Wang SF, Tian Y, Zheng XZ, Yang Y, Li K. Discussion on operative skills in the embolization of hydrosalpinx by hysteroscopic placement of a microcoil. Medicine (Baltimore) 2019; 98:e14721. [PMID: 30882637 PMCID: PMC6426551 DOI: 10.1097/md.0000000000014721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This study aims to discuss the operative skills of hysteroscopic tubal embolization and reduce the occurrence of complications.Ninety-four patients were divided into group A and group B. The main surgical technique in group A: when the inner sleeve is sent to the fallopian tube and no longer accessible (but no >3 cm), remove the guide wire and put into the microcoil. But in group B, there are four major surgical techniques. First, the depth at which the guide wire enters the tube was controlled at 2 cm. Second, the inner diameter of the fallopian tube must be explored to determine the type and shape of the coils. Third, saline should be used to separate the catheter. Fourth, it is to control the release speed of the coils. The superiority of the improved operation method was confirmed by comparing the surgical failure rate, incidence of complications, and cost of surgery before and after the procedure.The reoperation rate of group A was 10% (3/30), while that of group B was 2.68% (3/112). The ectopic microcoils rate of group A was 6.67% (2/30), while that of group B was 0.89% (1/112). The microcoil damages rate of group 23.33% (7/30), while that of group B was 8.04% (9/112). All P values were <.01, and the difference was statistically significant.Hysteroscopic tubal embolization is currently a new surgical procedure to block the fallopian tubes and prevent the reverse flow of fluid in the fallopian tubes into the uterine cavity. After we improved surgical techniques, the surgical failure rate, complication rate, and operation cost of fallopian tube embolization were significantly lower than before the improved method was applied. The improved techniques led to a higher success rate.
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Affiliation(s)
- Hua-Lei Cai
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Guizhou Medical University
| | - Le-Yun Pan
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Shun-Fang Wang
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Yu Tian
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Xiao-Zhu Zheng
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Yan Yang
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Kun Li
- Department of Surgical, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
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Wu YC, Huang XF, Yang HY, Chen X, Wang PY, Hu Y, Lin F. Fibered platinum coil: A novel option for the patients of hydrosalpinx with laparoscopic contradiction. Eur J Obstet Gynecol Reprod Biol 2018; 229:179-184. [PMID: 30205314 DOI: 10.1016/j.ejogrb.2018.08.579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/31/2018] [Accepted: 08/26/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To investigate the feasibility of proximal tubal occlusion with fibered platinum coils in subfertile women with hydrosalpinx, and to observe the clinical outcomes of subsequent treatment with in vitro fertilization and embryo transfer (IVF-ET). STUDY DESIGN A prospective study was carried out in a university-affiliated teaching hospital. 56 women with uni- or bilateral hydrosalpinx received fibered platinum coil placement before IVF-ET. The clinical pregnancy rate and live birth rate was evaluated. Data analysis was performed with SPSS version 22.0 (SPSS, Inc., Chicago, IL, USA), using two-sided test, and a p value < 0.05 was considered statistically significant. The study has been registered in the ClinicalTrials. gov with the number of NCT03395301. RESULT(S) Successful placement was achieved in 106 fallopian tubes of 55 patients. The fibered platinum coils induced complete proximal occlusion in 52 out of 55 patients in the following 3-month HSG examination. In the 52 patients, 44 patients received following IVF-ET. The clinical pregnancy rate reached 60.5%(23/38)and live birth rate reached 60.87% (14/23) in patients less than 40 years old. CONCLUSION(S) Fibered platinum coil is a new, safe and valuable device for hysteroscopic tubal proximal occlusion in subfertile women with hydrosalpinx but with laparoscopic contradictions to improve the reproductive outcomes of IVF-ET. Capsule: Fibered platinum coil is a new, safe and valuable device for hysteroscopic tubal proximal occlusion in subfertile women with hydrosalpinx to improve the reproductive outcomes of in vitro fertilization and embryo transfer.
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Affiliation(s)
- Yan-Cheng Wu
- The Department of Gynecology, First Affiliated Hospital of Wenzhou Medical University, Zhejiang, Wenzhou, 325000, PR China
| | - Xue-Feng Huang
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Zhejiang, Wenzhou, 325000, PR China
| | - Hai-Yan Yang
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Zhejiang, Wenzhou, 325000, PR China
| | - Xia Chen
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Zhejiang, Wenzhou, 325000, PR China
| | - Pei-Yu Wang
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Zhejiang, Wenzhou, 325000, PR China
| | - Yan Hu
- The Department of Gynecology, First Affiliated Hospital of Wenzhou Medical University, Zhejiang, Wenzhou, 325000, PR China.
| | - Feng Lin
- The Department of Gynecology, First Affiliated Hospital of Wenzhou Medical University, Zhejiang, Wenzhou, 325000, PR China.
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Cabezas-Palacios MN, Jiménez-Caraballo A, Tato-Varela S, Sánchez-Sánchez A, Romero-Díaz C, Carrasco-Gallego A, Zapardiel-Gutiérrez I. Safety and patients’ satisfaction after hysteroscopic sterilisation. J OBSTET GYNAECOL 2017; 38:377-381. [DOI: 10.1080/01443615.2017.1362549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Sara Tato-Varela
- Obstetrics and Gynecology Department, Virgen de la Macarena University Hospital, Seville, Spain
| | - Alicia Sánchez-Sánchez
- Obstetrics and Gynecology Department, Virgen de la Macarena University Hospital, Seville, Spain
| | - Carlos Romero-Díaz
- Obstetrics and Gynecology Department, Virgen de la Macarena University Hospital, Seville, Spain
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Pregnancy outcome of in vitro fertilization after Essure and laparoscopic management of hydrosalpinx: a systematic review and meta-analysis. Fertil Steril 2017; 108:84-95.e5. [DOI: 10.1016/j.fertnstert.2017.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 04/23/2017] [Accepted: 05/03/2017] [Indexed: 11/17/2022]
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8
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Barbosa MW, Sotiriadis A, Papatheodorou SI, Mijatovic V, Nastri CO, Martins WP. High miscarriage rate in women treated with Essure® for hydrosalpinx before embryo transfer: a systematic review and meta-analysis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2016; 48:556-565. [PMID: 27854386 DOI: 10.1002/uog.15960] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/26/2016] [Accepted: 04/29/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Essure® has been tested as an alternative treatment for hydrosalpinx before embryo transfer (ET) in women undergoing assisted reproduction techniques. However, the persistence of a foreign body inside the uterine cavity might have a negative impact on the outcome of pregnancy. The present systematic review aimed at identifying, appraising and summarizing the available evidence regarding the effectiveness and safety of using Essure prior to ET for women with hydrosalpinx. METHODS We searched for studies in PubMed, Scopus, CENTRAL, Web of Science and ClinicalTrials.gov and the reference lists of eligible studies. All studies including at least 10 women with hydrosalpinx who received Essure, any other intervention or no treatment prior to ET were considered eligible. Study selection, data extraction and evaluation of the risk of bias were performed independently by two authors. Study outcomes were miscarriage per clinical pregnancy, singleton preterm birth per singleton live birth and live birth/ongoing pregnancy and clinical pregnancy per ET. The pooled results for each outcome and intervention were summarized as proportions with their respective 95% CIs, using a random-effects model. RESULTS Our electronic search of databases was performed on 7 November 2015, and 26 studies with 43 study arms were considered eligible: eight study arms evaluating Essure; seven assessing tubal aspiration; seven appraising effects of no treatment; 12 evaluating salpingectomy; two assessing tubal division; and seven evaluating tubal occlusion. When compared with women who had no intervention, women with Essure had a higher clinical pregnancy rate per ET (36% (95% CI, 0-43%) vs 13% (95% CI, 9-17%)). When compared with women who had other interventions, women with Essure had a higher miscarriage rate per clinical pregnancy (38% (95% CI, 27-49%) vs 15% (95% CI, 10-19%)). CONCLUSIONS The available evidence suggests that, although Essure prior to ET in women with hydrosalpinx improves the chance of achieving a clinical pregnancy compared with no intervention, it is associated with a higher rate of miscarriage when compared with the other interventions. Although this evidence is based on observational studies, we believe that salpingectomy should be the first option for women who are eligible for videolaparoscopy. However, it is still premature to make recommendations for women who are not eligible for surgery, and randomized controlled trials are needed to clarify which is the best treatment alternative in such a scenario. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M W Barbosa
- University of Sao Paulo, Department of Obstetrics and Gynecology, Ribeirao Preto Medical School (FMRP-USP), Ribeirao Preto, Brazil
| | - A Sotiriadis
- Aristotle University of Thessaloniki, 2nd Department of Obstetrics and Gynecology, Thessaloniki, Greece
| | - S I Papatheodorou
- Department of Health Sciences, Cyprus Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - V Mijatovic
- Department of Reproductive Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - C O Nastri
- SEMEAR Fertilidade, Human Reproduction, Ribeirao Preto, Brazil
| | - W P Martins
- University of Sao Paulo, Department of Obstetrics and Gynecology, Ribeirao Preto Medical School (FMRP-USP), Ribeirao Preto, Brazil
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Cohen SB, Bouaziz J, Schiff E, Simon A, Nadjary M, Goldenberg M, Orvieto R, Revel A. In Vitro Fertilization Outcomes After Placement of Essure Microinserts in Patients With Hydrosalpinges Who Previously Failed In Vitro Fertilization Treatment: A Multicenter Study. J Minim Invasive Gynecol 2016; 23:939-43. [DOI: 10.1016/j.jmig.2016.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 05/17/2016] [Accepted: 05/23/2016] [Indexed: 11/25/2022]
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Dreyer K, Lier M, Emanuel M, Twisk J, Mol B, Schats R, Hompes P, Mijatovic V. Hysteroscopic proximal tubal occlusion versus laparoscopic salpingectomy as a treatment for hydrosalpinges prior to IVF or ICSI: an RCT. Hum Reprod 2016; 31:2005-16. [DOI: 10.1093/humrep/dew050] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 02/19/2016] [Indexed: 11/13/2022] Open
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Lorente González J, Ríos Castillo JE, Pomares Toro E, Romero Nieto MI, Castelo-Branco C, Arjona Berral JE. Essure a novel option for the treatment of hydrosalpinx: a case series and literature review. Gynecol Endocrinol 2016; 32:166-70. [PMID: 26513546 DOI: 10.3109/09513590.2015.1103221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Juan Lorente González
- a Department of Obstetrics and Gynecology , ''Reina Sofia'' University Hospital , Cordoba , Spain and
| | | | - Elvira Pomares Toro
- a Department of Obstetrics and Gynecology , ''Reina Sofia'' University Hospital , Cordoba , Spain and
| | | | - Camil Castelo-Branco
- 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
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El-Mazny A, Abou-Salem N, Hammam M, Saber W. Hysteroscopic tubal electrocoagulation versus laparoscopic tubal ligation for patients with hydrosalpinges undergoing in vitro fertilization. Int J Gynaecol Obstet 2015; 130:250-2. [DOI: 10.1016/j.ijgo.2015.04.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 04/04/2015] [Accepted: 06/11/2015] [Indexed: 10/23/2022]
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13
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Dreyer K, Hompes PG, Mijatovic V. Diagnostic accuracy of hysterosalpingo-foam-sonography to confirm tubal occlusion after Essure® placement as treatment for hydrosalpinges. Reprod Biomed Online 2015; 30:421-5. [DOI: 10.1016/j.rbmo.2014.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/05/2014] [Accepted: 12/15/2014] [Indexed: 12/01/2022]
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Legendre G, Moulin J, Vialard J, Ziegler DD, Fanchin R, Pouly JL, Watrelot A, BELAISCH Allart J, Massin N, Fernandez H. Proximal occlusion of hydrosalpinges by Essure® before assisted reproduction techniques: a French survey. Eur J Obstet Gynecol Reprod Biol 2014; 181:300-4. [DOI: 10.1016/j.ejogrb.2014.07.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/15/2014] [Accepted: 07/20/2014] [Indexed: 01/18/2023]
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Ozgur K, Bulut H, Berkkanoglu M, Coetzee K, Kaya G. ICSI pregnancy outcomes following hysteroscopic placement of Essure devices for hydrosalpinx in laparoscopic contraindicated patients. Reprod Biomed Online 2014; 29:113-8. [DOI: 10.1016/j.rbmo.2014.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 02/27/2014] [Accepted: 03/06/2014] [Indexed: 10/25/2022]
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Arora P, Arora RS, Cahill D. Essure®for management of hydrosalpinx prior toin vitrofertilisation-a systematic review and pooled analysis. BJOG 2014; 121:527-36. [DOI: 10.1111/1471-0528.12533] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2013] [Indexed: 11/30/2022]
Affiliation(s)
- P Arora
- Department of Reproductive Medicine; St Mary's Hospital; Manchester UK
| | - RS Arora
- Department of Medical Oncology; Max Super Speciality Hospital; New Delhi India
| | - D Cahill
- Academic Unit of Obstetrics and Gynaecology; St Michael's Hospital; Bristol UK
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Matorras R, Rabanal A, Prieto B, Diez S, Brouard I, Mendoza R, Exposito A. Hysteroscopic hydrosalpinx occlusion with Essure device in IVF patients when salpingectomy or laparoscopy is contraindicated. Eur J Obstet Gynecol Reprod Biol 2013; 169:54-9. [DOI: 10.1016/j.ejogrb.2013.02.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 01/10/2013] [Accepted: 02/04/2013] [Indexed: 10/27/2022]
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Legendre G, Gallot V, Levaillant JM, Capmas P, Fernandez H. Obturation tubaire d’un hydrosalpinx avant fécondation in vitro par Adiana® : à propos d’un cas. ACTA ACUST UNITED AC 2013; 42:401-4. [DOI: 10.1016/j.jgyn.2013.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Revised: 03/05/2013] [Accepted: 03/08/2013] [Indexed: 10/27/2022]
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Sonigo C, Collinet P, Rubod C, Catteau-Jonard S. Place actuelle des micro-implants Essure® dans la prise en charge des hydrosalpinx avant fécondation in vitro. ACTA ACUST UNITED AC 2013; 41:133-8. [DOI: 10.1016/j.gyobfe.2012.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Indexed: 10/27/2022]
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Tulandi T, Akkour K. Role of reproductive surgery in the era of assisted reproductive technology. Best Pract Res Clin Obstet Gynaecol 2012; 26:747-55. [DOI: 10.1016/j.bpobgyn.2012.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 04/11/2012] [Accepted: 04/27/2012] [Indexed: 10/28/2022]
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Moramezi F, Barati M, Mohammadjafari R, Barati S, Hemadi M. Effect of hysteroscopy before intra uterine insemination on fertility in infertile couples. Pak J Biol Sci 2012; 15:942-946. [PMID: 24159691 DOI: 10.3923/pjbs.2012.942.946] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Uterine disorders like usual infertility factors (male factor, ovarian and tubal problems of women) may affect the outcome of infertility treatment in infertile patients. In our clinical trial, 110 couples diagnosed with infertility were candidate for intra uterine insemination (IUI). The patients were divided randomly into two equal groups (n = 55): In group one (control group), patients without hysteroscopy underwent ovulation induction by clomiphene citrate and hCG followed by intrauterine insemination. The second group (experiment group), patients were undergoing hysteroscopy before intra uterine insemination on the day 21 of the cycle and due to abnormal findings, going under surgical treatment if they needed. The rates of pregnancy complications in patients were evaluated. The age, BMI, kind of infertility, duration of infertility, number of previous trial, duration of stimulation, the type of procedures used and semen analysis (TMC, Motility and morphology of sperm) were similar for both groups and no statistically significant differences emerged at all between them. In experimental group, hysteroscopy revealed pathology in the uterine cavity in 26 out of 55 cases. The overall rates of clinical pregnancy were higher in experimental group compared to the control group. The findings from this study showed that the use of hysteroscopy as a diagnostic or therapeutic procedure before IUI, can increase the rate of pregnancy and finally decrease the failure rate of infertility treatment and perinatal complications in infertile couples.
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Affiliation(s)
- Farideh Moramezi
- Fertility, Infertility and Perinatology Research Center, School of Medicine, Ahvaz Jundishapour University of Medical Sciences (AJUMS), Ahvaz, Iran
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Jerome D, Elizabeth B, Grace J, Charles K. Laparoscopic confirmation of hydrosalpinx is imperative prior to hysteroscopic occlusion for IVF to avoid permanent iatrogenic sterility. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2012. [DOI: 10.1016/s2305-0500(13)60054-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Thébault N, Broux PL, Moy L, Vialard J. Utilisation du micro-implant Essure® pour exclusion d’hydrosalpinx dans un contexte d’infertilité. ACTA ACUST UNITED AC 2012; 41:145-50. [DOI: 10.1016/j.jgyn.2011.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 12/02/2011] [Accepted: 12/07/2011] [Indexed: 10/14/2022]
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Omurtag K, Grindler NM, Roehl KA, Bates GW, Beltsos AN, Odem RR, Jungheim ES. How members of the Society for Reproductive Endocrinology and Infertility and Society of Reproductive Surgeons evaluate, define, and manage hydrosalpinges. Fertil Steril 2012; 97:1095-100.e1-2. [PMID: 22405598 DOI: 10.1016/j.fertnstert.2012.02.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 02/13/2012] [Accepted: 02/17/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the management of hydrosalpinges among Society for Reproduction Endocrinology and Infertility (SREI)/Society of Reproductive Surgeons (SRS) members. DESIGN Cross-sectional survey of SREI/SRS members. SETTING Academic and private practice-based reproductive medicine physicians. PARTICIPANT(S) A total of 442 SREI and/or SRS members. INTERVENTION(S) Internet-based survey. MAIN OUTCOME MEASURE(S) To understand how respondents evaluate, define, and manage hydrosalpinges. RESULT(S) Of 1,070 SREI and SRS members surveyed, 442 responded to all items, for a 41% response rate. Respondents represented both academic and private practice settings, and differences existed in the evaluation and management of hydrosalpinges. More than one-half (57%) perform their own hysterosalpingograms (HSGs), and 54.5% involve radiologists in their interpretation of tubal disease. Most respondents thought that a clinically significant hydrosalpinx on HSG is one that is distally occluded (80.4%) or visible on ultrasound (60%). Approximately one in four respondents remove a unilateral hydrosalpinx before controlled ovarian hyperstimulation (COH)/intrauterine insemination (IUI) and clomiphene citrate (CC)/IUI (29.3% and 22.8%, respectively), and physicians in private practice were more likely to intervene (COH: risk ratio [RR] 1.81, 95% confidence interval [CI] 1.31-2.51; CC: RR 1.98, 95% CI 1.33-2.95). Although laparoscopic salpingectomy was the preferred method of surgical management, nearly one-half responded that hysteroscopic tubal occlusion should have a role as a primary method of intervention. CONCLUSION(S) SREI/SRS members define a "clinically significant hydrosalpinx" consistently, and actual practice among members reflects American Society for Reproductive Medicine/SRS recommendations, with variation attributed to individual patient needs. Additionally, one in four members intervene before other infertility treatments when there is a unilateral hydrosalpinx present.
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Affiliation(s)
- Kenan Omurtag
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri 63108, USA.
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Essure® hydrosalpinx occlusion prior to IVF-ET as an alternative to laparoscopic salpingectomy. Eur J Obstet Gynecol Reprod Biol 2012; 161:42-5. [DOI: 10.1016/j.ejogrb.2011.12.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Revised: 10/31/2011] [Accepted: 12/01/2011] [Indexed: 11/21/2022]
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Tulandi T, Marzal A. Redefining reproductive surgery. J Minim Invasive Gynecol 2012; 19:296-306. [PMID: 22348901 DOI: 10.1016/j.jmig.2012.01.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 01/08/2012] [Accepted: 01/12/2012] [Indexed: 11/17/2022]
Abstract
With the availability of and improvements in in vitro fertilization (IVF), the role of reproductive surgery has been questioned. Yet, the scope of reproductive surgery today is much larger than in the past. Hysteroscopic correction of intrauterine disease is an important endoscopic procedure in women with infertility. Evidence suggests that correction of intrauterine disease is often followed by spontaneous pregnancy and improved IVF outcome. Hysteroscopic examination should be considered after 1 failed IVF. Today, it is clear that removal of the hydrosalpinx leads to a higher IVF-related live birth rate. The procedure should be performed thoroughly without compromising the ovarian blood supply. The IVF pregnancy rate is not affected by the presence of ovarian endometriomas, and small endometriomas need not be removed; however, large and symptomatic endometriomas that interfere with oocyte retrieval should be excised. When excision of the cyst wall is difficult, fenestration and ablation should be considered. This might lead to an increased recurrence rate, but is associated with less interference of the ovarian reserve. Although the role of reproductive surgery as primary treatment for tuboperitoneal infertility is limited, it has an important role in enhancing the outcome of IVF treatment and in preservation of fertility. Surgical preservation of fertility consists of ovarian suspension, ovarian excision for cryopreservation, and ovarian tissue transplantation.
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Affiliation(s)
- Togas Tulandi
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
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Fouda UM, Sayed AM. Effect of ultrasound-guided aspiration of hydrosalpingeal fluid during oocyte retrieval on the outcomes of in vitro fertilisation-embryo transfer: a randomised controlled trial (NCT01040351). Gynecol Endocrinol 2011; 27:562-7. [PMID: 20672903 DOI: 10.3109/09513590.2010.507290] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine whether the ultrasound-guided aspiration of hydrosalpingeal fluid at the time of oocyte retrieval can improve the outcomes of in vitro fertilisation-embryo transfer (IVF-ET). PATIENTS One hundred and ten women with ultrasound-visible hydrosalpinges were randomised to two groups based on computer generated randomisation list. Fifty-four women underwent ultrasound-guided aspiration of hydrosalpingeal fluid prior to IVF-ET and 53 women underwent IVF-ET without any prior intervention. RESULTS Patients who underwent aspiration of hydrosalpinges demonstrated a significantly increased implantation, clinical pregnancy rates. Among the patients in the aspiration group, the implantation rate and pregnancy rates were higher in the subgroup of patients with no reaccumulation of hydrosalpingeal fluid within the first 2 weeks after aspiration compared to patients with reaccumulation of hydrosalpingeal fluid within the first 2 weeks after aspiration, but this difference failed to reach statistical significance. Furthermore, no pregnancies occurred in the four patients with uterine fluid collection detected during IVF-ET cycles. CONCLUSION The aspiration of hydrosalpingeal fluid at the time of oocyte retrieval is simple, safe and effective procedure for treatment of patients with ultrasound-visible hydrosalpinges particularly those without rapid reaccumulation of hydrosalpingeal fluid after aspiration or uterine fluid collection during the IVF-ET cycles.
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Affiliation(s)
- Usama M Fouda
- Obstetrics and Gynaecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
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Galen DI, Khan N, Richter KS. Essure Multicenter Off-Label Treatment for Hydrosalpinx Before In Vitro Fertilization. J Minim Invasive Gynecol 2011; 18:338-42. [DOI: 10.1016/j.jmig.2011.01.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 01/21/2011] [Accepted: 01/26/2011] [Indexed: 11/28/2022]
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Solt I, Ioffe Y, Elmore RG, Solnik MJ. Group A Streptococcal Peritonitis and Ruptured Tubo-Ovarian Abscess Three Years After Essure® Insertion: A Case Report. J Womens Health (Larchmt) 2011; 20:781-3. [DOI: 10.1089/jwh.2010.2574] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ido Solt
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Yevgeniya Ioffe
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Raymond Geoffrey Elmore
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California
| | - M. Jonathon Solnik
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California
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Shah V, Panay N, Williamson R, Hemingway A. Hysterosalpingogram: an essential examination following Essure hysteroscopic sterilisation. Br J Radiol 2010; 84:805-12. [PMID: 21123309 DOI: 10.1259/bjr/95330860] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to describe our experience of imaging following hysteroscopic sterilisation with the Essure (Conceptus Inc., Mountain View, San Carlos, CA) microinsert, and to underline the importance of a carefully performed follow-up hysterosalpingogram (HSG) in the management of these patients. METHODS 18 women underwent the procedure and all returned for follow-up HSG. A standard HSG technique was used and views were acquired to establish microinsert position and tubal occlusion. RESULTS In 16 of the 18 women, adequate microinsert positioning and bilateral tubal occlusion was present. In one woman, a unilateral microinsert occluded the fallopian tube, whereas the other fallopian tube was ligated with a clip. The final patient underwent two studies; both showed well-positioned microinserts but unilateral free spill from the right fallopian tube. There are no reported pregnancies thus far. CONCLUSION Essure sterilisation coils have a unique appearance when radiographed and are an effective means of permanently occluding the fallopian tubes. HSG is a rapid and safe method of confirming satisfactory placement and tubal occlusion. Non-HSG imaging techniques are suboptimal at detecting patent fallopian tubes and expose patients to the risk of an unwanted and potentially complicated pregnancy.
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Affiliation(s)
- V Shah
- Department of Imaging, Hammersmith and Queen Charlotte Hospitals, Imperial College Healthcare NHS Trust, London, UK.
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Spontaneous intrauterine pregnancy after unilateral placement of tubal occlusive microinsert. Fertil Steril 2009; 92:393.e15-7. [DOI: 10.1016/j.fertnstert.2009.03.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2009] [Revised: 03/05/2009] [Accepted: 03/10/2009] [Indexed: 11/19/2022]
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Connor VF. Essure: A Review Six Years Later. J Minim Invasive Gynecol 2009; 16:282-90. [DOI: 10.1016/j.jmig.2009.02.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 02/08/2009] [Accepted: 02/18/2009] [Indexed: 10/20/2022]
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Mijatovic V, Veersema S, Emanuel MH, Schats R, Hompes PGA. Essure hysteroscopic tubal occlusion device for the treatment of hydrosalpinx prior to in vitro fertilization-embryo transfer in patients with a contraindication for laparoscopy. Fertil Steril 2009; 93:1338-42. [PMID: 19147140 DOI: 10.1016/j.fertnstert.2008.11.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2008] [Revised: 11/02/2008] [Accepted: 11/20/2008] [Indexed: 10/21/2022]
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.
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Affiliation(s)
- Velja Mijatovic
- Department of Reproductive Medicine, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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Abstract
Salpingectomy for hydrosalpinges before in vitro fertilization increases the success rate.
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