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Pregnancy after Essure placement: report of two cases.

Moses AW, Burgis JT, Bacon JL, Risinger J

Department of Obstetrics and Gynecology, University of South Carolina School of Medicine, Columbia, South Carolina, USA.

OBJECTIVE: To report two cases of pregnancy after placement of Essure micro-inserts. DESIGN: Case report. SETTING: University-based Department of Obstetrics and Gynecology. PATIENT(S): Patient 1, a 38-year-old woman, presented with a positive pregnancy test 7 months after Essure hysteroscopic sterilization. Patient 2, a 35-year-old female, became pregnant approximately 1 year after undergoing the Essure procedure. INTERVENTION(S): Patient 1 received obstetric ultrasounds, a prophylactic cerclage, a cesarean section, and a tubal ligation. Patient 2 underwent a postprocedure hysterosalpingogram, an obstetric ultrasound, pregnancy termination, diagnostic pelvic ultrasound, and a hysterectomy. MAIN OUTCOME MEASURE(S): Documentation of normal progress of pregnancy after Essure placement. RESULT(S): Patient 1 carried an uncomplicated pregnancy to term with an Essure micro-insert in place. Patient 2 became pregnant despite an hysterosalpingogram showing tubal occlusion and was ultimately found to have a micro-insert perforating the uterine wall. CONCLUSION(S): The presence of Essure micro-inserts in the fallopian tubes do not appear to interfere with implantation and pregnancy. Uterine perforation by an Essure micro-insert in proximity to the tubal ostia may mimic proper micro-insert placement and bilateral tubal occlusion on both hysterosalpingogram and saline infusion sonography.

Published 11 March 2008 in Fertil Steril, 89(3): 724.e9-11.
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