A Less Invasive Sterilization Option for Women
Female sterilization has traditionally been done with tubal ligation . This is a surgical procedure where the abdomen is entered and the fallopian tubes are cut and tied to keep eggs released from the ovaries from reaching the uterus. Essure, though, is a small metallic implant that is placed into a woman’s fallopian tubes. Unlike other sterilization procedures for women, no incision or general anesthesia is required.
How Does Essure Work?
A tool called a hysteroscope is inserted into the vagina and through the cervix, which allows the doctor to see inside of the uterus. The doctor then uses a thin tube to thread the Essure device through the vagina and then into the fallopian tube. This procedure is repeated to implant a second device into the other fallopian tube. The procedure causes pain in some women, but it is likely that pain is less than with other forms of permanent sterilization. Essure implants work by causing scar tissue to form over the implant. The scar tissue permanently blocks the fallopian tube and prevents fertilization of the egg by the sperm.
How Long Does It Take to Work?
Women must use an alternate birth control method for three months after the insertion of Essure implants, since it takes about that long for the scar tissue to grow. At the three-month point, the doctor checks to make sure that the device has been properly placed, and that the scar tissue has fully blocked the fallopian tubes. This is done with an injection of dye into the uterus followed by an x-ray . If implantation was successful, alternate contraception can be discontinued. In some cases, implantation is not successful.
Is It Effective?
About 1 out of 100 women will become pregnant during the first year after getting the Essure device. Pregnancies that do occur after sterilization are more likely to be ectopic pregnancies , which occur outside the uterus and can be life-threatening.
Other risks associated with Essure include:
- Infection
- Pelvic pain
- Blockage of the fallopian tube on only one side
- Damage to the uterus or fallopian tube during the procedure
Is This the Right Procedure for You?
Essure is not the right procedure if you:
- Want to become pregnant—Essure is permanent. You will not be able to have a baby.
- Recently had a baby or an abortion
- Have a pelvic infection
- Are allergic to nickel or contrast dye (used in imaging tests)
- Have a condition that affects your uterus or fallopian tubes
Talk to your doctor to find out if Essure is a good option for you.
RESOURCES:
Planned Parenthood
http://www.plannedparenthood.org/
US Food and Drug Administration
http://www.fda.gov/
CANADIAN RESOURCES:
The Canadian Women's Health Network
http://www.cwhn.ca/indexeng.html/
The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org/
References:
Clinical testing. Essure website. Available at: http://www.essure.com/Home/Understanding/ClinicalTesting/tabid/58/Default.aspx . Accessed August 4, 2008.
Duffy S, Marsh F, Rogerson L, Hudson H, Cooper K, Jack S, et al. Female sterilisation: a cohort controlled comparative study of ESSURE versus laparoscopic sterilisation. BJOG . 2005;112:1522-1528.
Essure System - P020014. US Food and Drug Administration website. Available at: http://www.fda.gov/cdrh/pdf2/p020014.html . Updated April 2003. Accessed August 4, 2008.
Female Sterilization (Essure). Planned Parenthood website. Available at: http://www.plannedparenthood.org/greater-iowa/female-sterilization-essure.htm . Accessed August 4, 2008.
Mayo Clinic. Essure. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/essure/MY00999. Updated April 2010. Accessed June 8, 2010.
Sterilization for men and women. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/PUBLICATIONS/PATIENT_EDUCATION/BP011.CFM . Accessed August 4, 2008.
Last reviewed June 2010 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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