ESSURE REVERSAL
EXPLAINED IN DETAIL
Most health care providers are unaware Essure can be reversed. The reality is Essure can be reversed and natural pregnancy is possible.
Essure causes the fallopian tubes to become blocked at the very beginning of the tube. The beginning of the tube is often referred to as the proximal (closest to the uterus) portion of the tube. Blockage of the proximal portion of the fallopian tube can be surgically corrected. The historical gold standard procedure for the surgical correction of proximal tubal blockage is a tubouterine implantation. Most people, including health care providers, are unaware the first successful surgery to reverse proximal occlusion of the fallopian tubes occurred in the early 1900’s!
Before we ever performed our first Essure reversal surgery, we had been performing tubouterine implantation for the reversal of proximal tubal occlusion from other types of tubal ligation.
Tubouterine implantation
An uncommon reversal technique
Most infertility specialists do not perform tubal ligation reversal and even less will perform tubouterine implantation.
Tubouterine implantation is much different than other types of tubal reversal procedures because it requires deep incisions be made into the uterine muscle. This will often increase the risk of surgery. Most doctors either don’t have the training to perform this specialized repair procedure or the awareness the surgery can safely be performed as an outpatient procedure.
We have been doing this for years and have a high degree of comfort with this type of reversal technique in the outpatient setting.
Tubouterine implantation
A Long history
Tubouterine implantation was performed in the late19th century. The first reports of tubal implantation were in European Journals and were very limited in description and success rate. Dr. Turck described the first successful tubouterine implantation resulting in pregnancy in 1909 in the New York Medical Journal.
The first modern reports of tubouterine implantation indexed in PubMed begin to appear in the 1950’s. Tubouterine implantation was then performed with more frequency in the 1960’s and 1970’s and was found to have pregnancy success rates as high as 60%. In the 1980’s IVF, became more popular and tubal ligation reversal surgery, as well as tubouterine implantation, began to be performed less often. This is the reason most doctors are unfamiliar with many of the techniques of tubal repair surgery.
Many of todays doctors have never seen the procedure and are not even aware tubouterine implantation is possible or can provide a reasonable chance of pregnancy success. Although the American Society for Reproductive Medicine supports tubal ligation reversal surgery, these infertility experts are of the position tubouterine implantation is of historical interest only.
We have had success with tubouterine implantation and have observed success rates similar to a single cycle of IVF with this type of tubal repair procedure. We have found with the introduction of the ‘newer’ Essure sterilization procedure that a ‘historical’ tubal repair procedure has found a new indication for use.
