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Essure
Background
B.C. type	Sterilization
First use	2002
Failure rates (per 4 years)
Perfect use	0.2%
Typical use	0.2%
Usage
Duration effect	Permanent
Reversibility	No
User reminders	Additional methods until 3 month check by hysterosalpingogram
Clinic review	None
Advantages
Benefits	Permanent contraception
Disadvantages
STD protection	No
Weight gain	No

Essure is a permanent sterilization procedure for women developed by Conceptus Inc and approved the use in the United States on November 4, 2002.^[1]

Contents 1 Procedure and assessment 2 Cautions and warnings 2.1 Risks 3 Notes 4 External links

Micro-inserts are placed into the fallopian tubes by a cathether passed from the vagina through the cervix and uterus. Once in place, the device is designed to elicit tissue growth (scarring) in and around the micro-insert to form over a period of 3 months an occlusion or blockage in the fallopian tubes; the tissue barrier formed prevents sperm from reaching an egg.

Unlike other forms of tubal ligation, no general anaesthetic nor incision through the abdomen is required. Somewhat similar to male vasectomy procedures, initially additional forms of birth control must be continued to prevent pregnancy until the method's effectiveness can be confirmed. For the Essure method, 3 months after insertion a physician performs a special type of x-ray test called a hysterosalpingogram to confirm that the fallopian tubes are completely blocked and the patient can rely on the Essure micro-inserts for birth control. Occlusion is observed to have occurred in 96.5% of patients at 3 months with the remainder occluded by 6 months.^[1]

The reported insertional failure rates are: "failure to place 2 micro-inserts in the first procedure (14%), initial tubal patency (3.5%), expulsion (2.2%), perforation (1.8%), or other unsatisfactory device location (0.6%)."^[2] Following successful insertion and occlusional response, the Essure procedure is 99.80% effective based on 4 years of follow-up.^[3] The Essure procedure has been demonstrated in a small portion of the women undergoing clinical studies to be 99.74% effective based on 5 years of follow-up. Five year follow-up of all patients in clinical trials is ongoing.

The micro-inserts do not prevent the transmission of sexually transmitted diseases. The procedure takes about 35 minutes for a trained physician to perform and can be performed in a physician's office. General anesthesia is not required. Unlike many temporary methods of birth control, the Essure micro-inserts do not contain or release hormones.

The micro-inserts being made from polyester fibers, nickel-titanium and stainless steel are safe to use with MRI equipment.^[2]

• Perforation, expulsion, or other unsatisfactory location of the micro-insert
• Pregnancy and increased risk of ectopic pregnancy
• Risks associated with anesthesia
• Pain, cramping, vaginal bleeding, menstrual pattern changes
• Nausea/vomiting, or fainting
• Vasovagal response

1. ^ ^{a b} Essure™ System - P020014. Food and Drug Administration (28 April 2003). Retrieved on December 12, 2006.
2. ^ ^{a b} Prescribing Information (PDF). Essure. Conceptus (8 September 2005). Retrieved on December 12, 2006.
3. ^ Clinical Testing. Essure. Conceptus. Retrieved on December 12, 2006.

• Essure official site

Birth control edit
Sterilization:	Tubal ligation, Vasectomy, Essure
Post-intercourse:	Abortion: Surgical, Medical Emergency contraception
Intra-uterine:	IUD, IUS (progestogen)
Anti-estrogen:	Ormeloxifene (a.k.a. Centchroman)
Hormonal:	Combined: COCP ('the Pill'), Patch, Nuvaring Progestogen only: POP mini-pill, Depo Provera, Norplant, Implanon
Barrier:	Male condom, Female condom, Diaphragm, Shield, Cap, Sponge, Spermicide
Behavioral:	Coitus interruptus, Rhythm Method, Lactational, Fertility awareness Avoiding vaginal intercourse: Anal sex, Oral sex, Outercourse, Masturbation, Abstinence