The Essure procedure is a permanent form of birth control involving placement of a small coil into each of a woman's fallopian tubes. Tissue grows around the inserts, effectively blocking the passage of eggs or sperm. Essure is performed as a same-day procedure in a clinic or hospital. While minimally invasive and 99.74 percent effective, it may not be the best form of contraception for every woman.
Uncertainty About Future Fertility
The results of an Essure procedure should be considered permanent. While surgical reversal is possible, it does not guarantee future pregnancy, and carries increased health risks including the possibility of ectopic pregnancy.
Major Life Changes or Stressors
Because of the long-term results of the Essure procedure, a woman's decision to have it should not be influenced by pressure from others or by a short-term situation. Doctors are trained to have a woman wait a period of time after her first request for permanent sterilization to ensure she still desires the procedure once she has had time to consider her choice and its consequences.
Pregnancy
If a woman is pregnant or thinks she may be pregnant, the Essure procedure cannot be performed because of the risk to the embryo or fetus.
Pregnancy Within the Previous Six Weeks
Following a pregnancy the lining of the uterus sheds, making it difficult for the doctor to see clearly and accurately place the inserts. Depending on how far the pregnancy progressed, the openings of the fallopian tubes may have stretched too wide to securely hold the inserts in place. The tubes return to their pre-pregnancy size with time.
Pelvic Infection
With a current or recent infection in the pelvic area, this minimally invasive surgical procedure carries the risk of spreading infection to the uterus, fallopian tubes and abdomen.
Nickel Allergy
Each Essure coil contains a small amount of nickel, which could potentially cause irritation. A simple skin test can be performed if a woman is not sure whether she has an allergy.
Unwillingness to Use Alternative Birth Control
Three months after the Essure prodecure, a hysterosalpingogram (HSG) or dye test is performed to determine whether complete blockage of the fallopian tubes has been achieved. A woman must use another form of birth control between the time of the initial procedure and the follow-up test to prevent pregnancy.
Contrast Media Allergy
To know whether the Essure procedure is successful, radio-opaque fluid or dye is placed in the uterus while x-rays are taken to make sure this contrast medium stays in the uterus and does not flow out through the fallopian tubes. Some people are allergic to the dye or combination of ingredients in it.
