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Hysteroscopic tubal occlusion using iso-amyl-2-cyanoacrylate in patients with hydrosalpinx
Mohamed I M Amer1, Mortada E Ahmed2, Dalal A Hassan3
1Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.
Aim:
The aim of this work is to assess the effectiveness of hysteroscopic tubal occlusion using iso-amyl-2-cyanoacrylate, among infertile women with hydrosalpinx prior to in vitro fertilization (IVF).
Methods:
Hysteroscopic injection of fallopian tubes with hydrosalpinx by 0.5 mL iso-amyl-2-cyanoacrylate was done in 40 infertile women planning for IVF. The patients were then followed-up after 1 and 3 months, with hysterosalpingography (HSG) to confirm complete tubal occlusion. Reinjection with iso-amyl-2-cyanoacrylate was done in these patients with incomplete tubal occlusion after 1 month of the first injection, followed by HSG 2 months later to confirm complete tubal occlusion. Data were prescribed as range, mean and standard deviation (for parametric variables) and range, number and percentage (for categorical variables).
Results:
The total number of tubes injected in this study was 54, 42 (77.8%) of which were completely occluded after one injection while 12 (22.2%) were partially occluded. Reinjection of the partially occluded tubes was done, and (HSG) of all patients after 3 months of the primary injection confirmed 48 (88.9%) of the tubes completely occluded while 6 (11.1%) remained partially occluded. Thirty-two (80%) patients underwent one cycle of IVF/ET (embryo transfer), while 8 (20%) patients did not appear for follow-up. Among the patients who underwent IVF/ET, 24 (75%) got pregnant, while 8 (25%) failed to conceive. Among the pregnant patients, 8 (33.3%) delivered at term, 3 (12.5%) had first trimester abortion, while the remaining 13 (54.2%) did not deliver yet.
Conclusion:
Iso-amyl-2-cyanoacrylate used for hysteroscopic tubal occlusion in patients with hydrosalpinx prior to IVF is safe and effective.
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