Permanent Contraception

Essure Micro-Insert for Female Sterilization

Failure Rate: low

Essure is a method of permanent birth control (sterilization) for women. The procedure involves the placement of a small metal coil into the fallopian tubes. The doctor implants the coils by threading them through the vaginal opening. Unlike other sterilization procedures for women, this system does not require cutting or general anesthesia. Over a 3-6 month period, scar tissue forms over the coils, blocking the fallopian tubes so that sperm can not reach and fertilize a woman's egg.

During the first three months, the Essure device is not fully effective, and couples must use another type of birth control. After this time, the woman returns to the doctor to have a special type of x-ray to confirm that the fallopian tubes are completely blocked. Some women require more time for the scaring to become complete and return for another x-ray in six months.

Essure is not an IUD

Although the Essure system is a coiled birth control device placed into the body by a doctor, it is not considered an intrauterine device (IUD). An IUD is placed in the uterus and it is reversible, whereas the Essure device is placed in the fallopian tube and it is permanent. The Essure system prevents pregnancy by creating a barrier to sperm, whereas the IUD has multiple birth control mechanisms that may affect the ovum, sperm, and fertilized egg.

Effectiveness of Essure

Essure is 99.74% effective based on 5 years of clinical data and is the most effective method of permanent birth control available. In clinical trials, the method was extremely effective in preventing pregnancy (no pregnancies resulted).

Side-Effects and Health Risks

This method does have some potential health concerns and side-effects. The coils may be difficult for the doctor to insert properly, or they may be expelled from the uterus. In clinical studies, about a third of women experienced cramping or pain surrounding the insertion procedure. About 6% experienced painful changes to their menstrual cycles. If a pregnancy does occur with the coil in place, it may be ectopic (tubal), which is life-threatening and requires emergency surgery. Further risks and contraindications are detailed in product information literature and should be discussed with a physician.

Reversibility of Essure

• Essure should not be used by women who cannot use an alternative method of birth control for at least three months after the implant.
• Because this device permanently prevents a woman from conceiving, it should not be used by women who might want to become pregnant in the future.
• If device removal is required for any reason, it will likely require surgery, including an abdominal incision, general anesthesia, and possible hysterectomy. Some clinics will attempt reversals for women who want to try to become pregnant, but there is not yet any reliable data on the safety and effectiveness of this procedure.
• To date there have only been a few successful reversals of Essure.
• In Vitro Fertilization (IVF) is not a good an option for women who have Essure becuase part of the coil sticks into the uterus.

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Related Articles

• Intrauterine Device Overview
• Go to next section Vasectomy
• Device Approvals and Clearances of Essure from FDA

Image Credit: R. A. Hatcher et al., "Contraceptive Technology," 16th Revised Ed., Irvington Publishers, 1994. p. 386.