What Is Transcervical Sterilization?
Transcervical sterilization involved a procedure in which a device was inserted into the fallopian tubes through the cervix. The most well-known transcervical sterilization method was Essure, which used small coils placed in the fallopian tubes to induce scar tissue formation that blocked the tubes. This method was considered permanent and did not require general anesthesia or incisions, though it required follow-up testing to ensure the tubes were fully blocked.
While transcervical sterilization was once a popular option, it is no longer available due to product discontinuations. Those seeking permanent contraception are generally advised to explore other surgical methods like tubal ligation or salpingectomy.
What Was Essure?
Essure was a form of permanent birth control introduced as a non-surgical alternative to traditional tubal ligation.
Approved by the U.S. Food and Drug Administration (FDA) in 2002, Essure was designed to provide women with a convenient and effective method of contraception. The device consisted of a small, soft, flexible coil made of metal and fiber that was inserted into the fallopian tubes through the cervix, without the need for incisions or general anesthesia. Over the course of several months, the body’s natural response to the coil led to the formation of scar tissue, which blocked the fallopian tubes and prevented sperm from reaching the eggs, thus preventing pregnancy.
Essure was manufactured by Conceptus, Inc., a medical device company that specialized in women's health products. In 2013, Conceptus was acquired by Bayer, a global pharmaceutical and life sciences company for 1.1 billion dollars, which continued to market and distribute Essure.
Despite its effectiveness, the product faced significant controversy due to reports of complications such as chronic pain, device migration, perforation of the uterus or fallopian tubes, and other side effects. As a result of these issues and lawsuits, Bayer ultimately discontinued the product in 2018.
How Did The Essure Implant work?
Once the Essure Implants were in place they worked by making scar tissue form over the implant, blocking the fallopian tube and preventing fertilization of the egg by the sperm.
How Was Transcervical Sterilization performed?
The procedure did not require cutting into the body or the use of radio frequency energy to burn the fallopian tubes. Instead, a health care professional inserted the soft, flexible implants through the body’s natural pathways (vagina, cervix, and uterus) and placed one into the opening of each of the two fallopian tubes. The very tip of the device remained outside the fallopian tube, which provided immediate visual confirmation that it was in place.
What Could A Patient Expect After The Procedure?
During the 3 months following the procedure, the patients body formed scar tissue over the inserts to form a natural barrier that prevented sperm from reaching the egg. During this period, the patient had to continue using another form of birth control like a condom.
After three months, a confirmation test was performed to verify that the patient was protected from the possibility of an unplanned pregnancy. The test used a dye and special type of x-ray to ensure both that the inserts were in place and that the fallopian tubes were completely blocked.
How Effective Was The Essure Implant/Transcervical Sterilization?
Essure was considered to be over 99% effective in preventing pregnancy once the scar tissue had fully developed and the fallopian tubes were blocked. This level of effectiveness was comparable to other permanent birth control methods, such as tubal ligation.
What were the advantages?
- No surgery, burning or anesthesia
- No hormones
- No slowing down to recover
- Could be performed in less than 30 minutes
- Allowed sexual spontaneity and required no daily attention.
- Was a permanent form of birth control
- There were no changes in sexual desire, menstrual cycle, or ability to breastfeed
- May be covered by Heath Insurance
What were the disadvantages?
- May not be reversible.
- Was meant to be a permanent form of birth control, something some may regret later
- Could be expensive, usually around $2,000 with insurance covering a portion
- Allergic reaction to the materials
- Perforation, expulsion, or other unsatisfactory location of the micro-insert
- Symptoms during or immediately after the procedure may include mild to moderate cramping, nausea/vomiting, dizziness/light-headedness, and bleeding/spotting
- Not all patients achieved successful placement of both inserts
Alternatives For Permanent Birth Control?
There are several alternative permanent methods of birth control, each offering a different approach to sterilization or permanent contraception. These options are suitable for those who are certain they do not want to have children in the future. To learn more check out my page on permanent birth control.
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