Contraception / Sterilisation
There are several options for temporary or reversible contraception including the contraceptive pill, progesterone injections, Implanon, IUDs, diaphragm, condoms, etc.
When permanent or definitive contraception is required, there are two main surgical options:
Hysteroscopic intra Fallopian tube permanent contraception
The procedure consists of inserting titanium coils inside the Fallopian tubes from inside the uterine cavity using a hysteroscope. The body grows scar tissue around the coils blocking the tubes and preventing future pregnancies.
It is a day procedure where no incisions are made. Recovery is immediate, with most women going back to work or their everyday activities the following day.
Frequently Asked Questions
Who should seek permanent contraception ?
Permanent contraception or sterilisation should be considered by couples who have completed their families, are certain they do not want any more children and have decided that do not want any of the temporary or reversible contraceptive options (pill, IUD, injections, implants, etc)
What is the difference between a tubal ligation and the Essure procedure ?
A tubal ligation is done through a Laparoscopy which involves two 1 cm incisions to the abdomen, one over the belly button and one just above the pubic bone. Through those incisions clips are applied to the outside of the tube occluding them.
The Essure procedure is done through a hysteroscopy which means insertion of a scope inside the uterus from below where there already is a natural opening (where the menstrual flow comes through). Two small metal coils are inserted inside the tubes promoting their occlusion.
Some advantages are a less invasive procedure, with faster post operative recovery, no incisions and no scars.
Which method should I choose ?
You should discuss both options with your doctor and decide which one suits you best. Everything else being equal, Essure have considerable advantages over tubal ligation.
What is the efficacy of permanent contraception ?
Tubal ligations have an overall failure rate of about 1 in 500. Essure is close to 100% safe.
Who should not have permanent contraception ?
Anyone who is not 100% certain that they do not want more children.
What happens if I change my mind? Can the procedure be reversed ?
Most people who ask for a tubal ligation or Essure are certain at the time that the family is complete. When they change their minds it is usually because of some unfortunate event or change in life circumstances such as divorce and a new partner.
A tubal ligation can be reversed through an operation to reconnect the tubes (tubal reanastomosis). The operation is not always successful and another possible option is IVF.
Essure cannot be reversed and IVF success rates are still not well known.
Both procedures should be seen as definitive. If there is any doubt that fertility is no longer wanted, temporary reversible methods should be used.
Will sterilisation have any unwanted consequences to my health?
Nothing should change. You will still be ovulating, producing the same levels of hormones, having regular menstrual cycles, etc. The only thing to consider are the surgical risks of the procedure itself and these are fairly small.