Is there a role for hysteroscopic tubal occlusion of functionless hydrosalpinges prior to IVF/ICSI in modern practice?

Abstract

This preliminary study demonstrates the feasibility of hysteroscopic tubal occlusion of functionless hydrosalpinx in all cases with acceptable efficacy. It has the advantage of adding a valuable evaluation of the endometrial cavity prior to IVF/ICSI. It should be an option for treatment protocol in cases of functionless hydrosalpinges. Further large sample-sized studies are required to test its impact on the implantation rate and clinical outcome.

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

“…We further examined the remaining 64 records for eligibility. We excluded 29 studies (from 32 records) for the following reasons: one study (from one record) was still ongoing; six studies (from six records) were not written in a Western language; 14 studies (from 15 records) evaluated fewer than 10 women; six studies (from six records) had insufficient data to evaluate eligibility and the authors did not respond to our electronic attempt to contact them; and two studies (from four records) did not provide IVF results. Therefore, 26 studies (from 32 records) were considered eligible.…”

Committee opinion: role of tubal surgery in the era of assisted reproductive technology

“…Proximal tubal occlusion for hydrosalpinges has also been accomplished hysteroscopically with Essure coil inserts, but data on IVF success rates are limited to a few very small case series (53,54). The trailing coils within the endometrial cavity may have the potential to act as an intrauterine contraceptive device, limiting embryo implantation with IVF.…”

“…When considering tubal anastomosis, the woman's age is the most important prognostic factor (54,58). In women younger than 40 years of age, the cumulative intrauterine pregnancy rate at 2 years is 70%, compared with more than 90% after microsurgical reversal of tubal sterilization (58)(59)(60).…”

Tubal Surgery in Assisted Reproduction Techniques

“…Proksimal tubal oklüzyon histeroskopik olarak Essure tel halkalarının yerleştirilmesi ile de başarılmıştır ama IVF başarı oranı dataları birkaç küçük vaka serileri ile sınırlıdır. 37,38 Endometrial kavitedeki tel halkaların intrauterin kontraseptif araç gibi etki potansiyeli olabilir ve IVF sırasında embriyo implantasyonunu sınırlandırabilir. Yerleştirildikten sonra histeroskopik olarak 1 yıl içinde hastaların %17'sinde ve 13-43 ay sonra %25'inde Essure halkalarının komplet doku enkapsülasyonu gözlenir.…”