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Permanent Sterilization

Many people refer to permanent sterilization as getting their “tubes tied.”  Permanent sterilization or tubal ligation has been available for many years and over that time many different techniques have been used.  In the past, the techniques for permanent sterilization required one or more incisions in the abdomen.  In 2002 a new method became available to allow physicians to provide permanent sterilization without any incisions.  This is done by placing a camera (called a hysteroscope) through the cervix and into the uterus. From inside the uterus the opening where the fallopian tube comes into the uterus can be seen (tubal ostia).  Once the tubal ostia are visualized soft, flexible coils can be placed into the fallopian tubes.  Over the next three months tissue grows into the fallopian tube over the inserts that were placed and creates a blockage. Pregnancy is prevented by not allowing sperm to reach the egg.  A test is required at 3 months to confirm complete blockage of the fallopian tubes and to assure reliable birth control.  This test is called a hsyterosalpingogram or HSG.  An HSG is done by placing contrast liquid into the uterus and using an x-ray to confirm blockage of the fallopian tubes.  The two options available for this type of permanent sterilization are Essure and Adiana.  Essure has been available since 2002 and Adiana since 2009.  Both can be done with minimal sedation and without general anesthesia. While not everyone is a candidate for transcervical sterilization it is a good option for most people considering permanent sterilization.

Common questions include:
1) Are there hormones involved?  No, the coils are hormone free.
2) Will I continue to have a period?  Yes.
3) Are these procedures reversible?  No, it is considered permanent.
4) Is this 100% effective? No permanent sterilization is 100% effective, however efficacy rates are very high at greater than 98%. This rate is similar to other forms of permanent sterilization.
5) It is covered by insurance?  Often these procedures are covered by insurance.
6) Will I need to use birth control after the procedure?  Yes.  Another form of birth control is required until the confirmatory test is done 3 months following placement.

Women’s Clinic of JCMG provides both Adiana and Essure as an option for permanent sterilization in addition to more traditional methods.