Regret following hysteroscopic tubal sterilization

Introduction. - The definitive contraception techniques are irreversible. Women opting for this type of contraception may therefore regret their decision later. Since 2002, the number of tubal sterilizations performed by the Essure (R) technique has steadily increased to more than 100,000 procedures to date. Due to the simplicity of the technique, the low operative risk and the absence of anesthesia, in most cases hysteroscopic sterilization is now the first tubal sterilization technique in France. The rate of regret after hysteroscopic tubal sterilization has never been evaluated. The purpose of this study is to evaluate the regret after hysteroscopic sterilization with Essure (R). Methods. - All patients who benefited hysteroscopic sterilization by Essure (R), in two teaching departments of obstetrics and gynecology of the same university, between June 2005 and December 2011 were included in this study. Patients with a medical indication for tubal sterilization or patients with an obturation of hydrosalpinx before in vitro fertilization were excluded. A specific questionnaire to assess patients regret was sent by post to all patients. Results. - During the study period, 452 hysteroscopic sterilizations were performed. Three hundred and six patients (67%) completed and returned the questionnaire. The average age of patients at the procedure was 41.4 [39.1, 43.7]. Mean follow after sterilization was 43 months [40.1, 45.9]. Seventeen of 306 patients (5.5%) expressed a sense of regret after sterilization. Seven women out of 306 (2.3%) consulted to discuss the possibility of a new pregnancy. None of these patients has finally resorted either to adopt or to medically assisted procreation. Conclusion. - The regret after tubal sterilization by hysteroscopy is a rare event. All patients asking for a permanent contraception technique should be informed of the irreversible nature of the technique. (C) 2013 Elsevier Masson SAS. All rights reserved.