Hydrosalpinx and Hysteroscopy


Around 10-30% of couples presenting with infertility have hydrosalpinx. Alternative treatments include achieving tubal occlusion by devices inserted hysteroscopically. Both Essure ® and Adiana ® have been used in this context, however for infertility purposes most of the studies have been done with Essure ®- off label use. The Essure® device is a spring like device consisting of a stainless steel inner coil and a nickel titanium elastic outer coil and polyethilne fibers. The device is usually performed in an outpatient setting, with local or no anesthesia at all. Sterilization is not immediate and women
should use additional contraception for another 3 months. Rosenfield et al. in 2005 reported the first successful live birth following Essure ® placement, in an obese woman with extensive pelvic adhesions.

A systematic review on the efficacy and safety of Essure® in the management of hydrosalpinx before IVF was published in 2014. Overall 115 women in 11 studies received Essure ®, which was successfully placed 96.5% of women and tubal occlusion was achieved in 98.1%. The subsequent IVF resulted in 38.6% pregnancy rate and 27.9% live birth rate per embryo transfer.




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