Reversible Mechanical Contraception and Endometriosis Treatment Using Stimuli-Responsive Hydrogels

Alexandre H. C. Anthis, Samuel Kilchenmann, Manon Murdeu,Paige J. LeValley, Morris Wolf, Charlotte Meyer,Oscar Cipolato,Mark W. Tibbitt,Jachym Rosendorf,Vaclav Liska,Thomas Rduch,Inge K. Herrmann

ADVANCED MATERIALS(2024)

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摘要
Female sterilization via fallopian tube ligation is a common procedure; However, after the operation, over 10% of women seek re-fertilization, which is frequently unsuccessful. In addition, there is evidence that fallopian tubes contribute to the spread of endometriotic tissue as they serve as channels for proinflammatory media entering the abdominal cavity via retrograde menstruation. Here, stimuli-degradable hydrogel implants are presented for the functional, biocompatible, and reversible occlusion of fallopian tubes. The hydrogel implants, designed with customized swelling properties, mechanically occlude fallopian tubes in a high-performance manner with burst pressures reaching 255-558 mmHg, exceeding normal abdominal pressures (95 mmHg). Their damage-free removal can be achieved within 30 min using near-visible UV light or a glutathione solution, employing a method akin to standard fallopian tube perfusion diagnostics. Ultrasound-guided implant placement is demonstrated using a clinical hysteroscope in a human-scale uterus model and biocompatibility in a porcine in vivo model. Importantly, the prevention of live sperm as well as endometrial cell passage through blocked fallopian tubes is demonstrated. Overall, a multifunctional system is presented that constitutes a possible means of on-demand, reversible contraception along with the first-ever mechanical approach to abdominal endometriosis prevention and treatment. A novel stimuli-degradable hydrogel implant for reversible fallopian tube occlusion, offering an alternative to permanent sterilization and endometriosis treatment, is introduced. These hydrogel implants mechanically block the tubes with high effectiveness and are removable within 30 min using UV light or a glutathione solution. Demonstrating in ex vivo and in vivo models, this multifunctional system provides a potential method for on-demand contraception and a mechanical approach to prevent and treat abdominal endometriosis. image
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关键词
implant,non-hormonal treatment,on demand,retrograde menstruation,women's health,Sampson's theory
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