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Risks associated with the Essure system include:

• Tubal blockage occurring on only one side
• Perforation of the uterus or fallopian tubes
• Pelvic pain
• Infection

You may not be able to have further pelvic electrosurgical procedures, such as some types of endometrial ablation, after having the Essure system implanted.

The Essure system doesn't offer protection from sexually transmitted infections (STIs).

In the first year after implantation of the Essure system, fewer than 1 out of 100 women will get pregnant. The risk of unintended pregnancy is likely highest during the first three months after the placement of the Essure system.

If you do conceive after having the Essure system inserted, there's a higher chance that the pregnancy will be ectopic — when fertilization happens outside the uterus, usually in a fallopian tube.

Before you have the Essure system inserted your health care provider will likely:

• Review the risks and benefits of reversible and permanent methods of contraception
• Ask about your reasons for choosing sterilization and discuss factors that could lead to regret, such as a young age or marital discord
• Explain the details of the procedure
• Discuss the causes and probability of sterilization failure
• Reinforce that the Essure system can't be reversed
• Discuss the need for you to use another method of contraception for three months after the procedure, or until tubal blockage is confirmed
• Help you choose the best time to do the procedure
• Discuss the risks of sexually transmitted infection (STI) and explain the need for condom use if you are at high risk of STI

Your health care provider will need a clear view of your tubal openings to insert the Essure system. He or she may recommend having the procedure done shortly after your period. If your periods are irregular, he or she may recommend using a hormonal contraceptive that contains progestin — such as the combination birth control pill, minipill or contraceptive injection (Depo-Provera) — to thin the lining of your uterus (endometrium).

The Essure system is usually inserted by visualizing the fallopian tubes using a hysteroscope — a thin tube equipped with a camera lens — as an outpatient procedure. The procedure typically takes 30 minutes or less. You may be given medication before the procedure to minimize spasm of your fallopian tubes and reduce pain from the procedure.

During the procedure

Your health care provider will insert a hysteroscope through your vagina and cervix into your uterus and check to make sure both fallopian tube openings are accessible. Using a small catheter attached to the hysteroscope, your health care provider will place tiny coils inside your fallopian tubes.

After the procedure

You may be allowed to go home immediately after the procedure and return to your normal activities the same day. Side effects may include:

• Cramping
• Abdominal pain
• Nausea or vomiting
• Dizziness or lightheadedness
• Bleeding or spotting

Contact your health care provider immediately if:

• You have severe or persistent pelvic pain
• You pass a coil

During the three months following the procedure, you must use another method of contraception. After three months, you will have an X-ray (hysterosalpingography) or an ultrasound to confirm the correct placement of the Essure system and verify that your fallopian tubes are blocked. If the procedure is successful, you can stop using other forms of birth control at this point.

If you think you're pregnant at any time after the procedure, contact your health care provider immediately. The Essure system doesn't affect your menstrual cycle.

The Essure system isn't reversible. Couples who want to try in vitro fertilization need to be aware that a portion of the coil protrudes into the uterine cavity. Because of this, the Essure system may interfere with the success of in vitro fertilization (IVF).