Essure

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Placing the Essure coil

Essure is a permanent birth control method in which tiny metal coils are placed in a woman's fallopian tubes. Over time, scar tissue grows in and around these coils, which block the tubes so that sperm can't reach a woman's eggs. It's unlike other sterilization procedures because it doesn't require incisions.

The flexible coil is 4 centimeters in length. It expands to a diameter of 1 to 2 millimeters once in place.

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Effectiveness rate. Essure has an effectiveness rate of 99.7 percent to 99.8 percent. That means two to three women out of 1,000 who rely on this method will get pregnant. Essure isn't intended for women who might wish to become pregnant in the future.

Side effects and health risks. The most commonly reported side effects in the clinical studies included mild to moderate pain during the procedure and vaginal bleeding for a few days afterward. The rare pregnancy that occurs after the Essure procedure is more likely to be a tubal ectopic pregnancy, one in which the fertilized egg starts developing in the fallopian tube. Ectopic pregnancies require immediate surgical removal, or the fallopian tube could rupture. Essure doesn't protect against STDs.

What to expect. Before the coils are placed, you receive a local anesthetic. Your doctor then inserts a narrow instrument called a hysteroscope into your vagina, through your cervix and into your uterus. The hysteroscope is connected to a video monitor, allowing your doctor to see the openings of your fallopian tubes and place the tiny coils inside them, using a small catheter attached to the hysteroscope. During the three months following the procedure, you must use another type of birth control. After three months, you get an X-ray to confirm that your fallopian tubes are blocked. If the procedure is successful, you can stop using backup birth control.

Cost. The cost of Essure ranges from about $1,300 to $3,500.