The Effect of Menstrual Phase and Hormonal Contraception on Successful Bilateral Placement of the Essure Micro-Insert Tubal Coil
Bibliographic record
Abstract
Some investigators have suggested that insertion of the Essure microinsert tubal coil should be completed in the follicular phase to improve visualization of the tubal ostia and ensure successful placement. Others have proposed that hormonal endometrial suppression with drugs before the procedure also improves visualization. Timing the procedure according to the follicular phase of the menstrual cycle is impractical for many physicians due to scheduling problems and is difficult to accomplish in women who have irregular menstrual cycles. Moreover, suppressive hormonal therapy is contraindicated for some women and may be problematic for those who choose permanent sterilization to avoid the use of hormonal contraceptives. There are little or no data on the effects of cycle timing or endometrial suppression on improving successful Essure coil placement. This retrospective study investigated the effect of the menstrual cycle phase timing and preoperative endometrial suppression using hormonal contraceptives on the successful bilateral placement of the Essure microinsert coil. The study subjects were 84 patients of reproductive age who underwent the procedure at a Canadian ambulatory center. Data were obtained by a retrospective review of clinical charts (Canadian Task Force classification II-2). The primary study outcome measure was successful placement of the Essure micro-insert tubal coil (defined as bilateral visualization of the tubal ostia and cannulation with the coil on the first attempt). Visualization of the tubal ostia was achieved 81 of 84 patients (96%) and was followed by successful bilateral placement of the coil in 78 of 81 (96%). Among menstrual cycle phases, no difference was found in success rates for parameters of visualization, placement or visualization of proper coil placement (P = 0.959, P = 0.955, P = 0.307, respectively) or for these same parameters between women using hormonal versus nonhormonal methods of contraception (P = 0.557, P = 0.542, P = 0.506). These findings indicate that success rates for bilateral placement of the Essure micro-insert coil on first attempt are very high, and are not improved by menstrual phase timing or preoperative hormonal endometrial suppression.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".