Proximal occlusion of hydrosalpinx by hysteroscopic placement of microinsert before in vitro fertilization-embryo transfer.

OBJECTIVE

To describe proximal occlusion of a hydrosalpinx by hysteroscopic placement of a microinsert before IVF-ET.

DESIGN

Case report.

SETTING

Health maintenance organization and tertiary-care assisted reproductive technology unit.

PATIENT(S): Obese, infertile woman with pelvic adhesive disease and unilateral hydrosalpinx.

INTERVENTION(S): Hysteroscopic placement of a microinsert into the proximal segment of a fallopian tube that was distally obstructed by hydrosalpinx. No intraoperative or postoperative complications occurred with hysteroscopic placement of microinsert.

MAIN OUTCOME MEASURE(S): Nonincisional proximal tubal occlusion under local anesthesia and intravenous sedation. Pregnancy by IVF-ET.

RESULT(S): No intraoperative or postoperative complications with hysteroscopic placement of microinsert were seen. After uterine transfer of three embryos, dichorionic-diamniotic twins were delivered by cesarean section at 34 weeks of gestation.

CONCLUSIONS(S): Hysteroscopic placement of a microinsert to proximally occlude a hydrosalpinx might be an alternative to laparoscopic proximal tubal occlusion or salpingectomy in patients with tubal disease planning IVF-ET.