title: Hysteroscopy and contraception.
abstract: The Essure method is the only available hysteroscopic sterilisation method. A 4-cm device is placed in the fallopian tubes, which then induces an inflammatory reaction that causes occlusion. The method has a high successful placement rate and high effectiveness, and it can be performed in an office setting without anaesthesia. Three months after the procedure, a confirmation test has to be conducted to assure a correct position of the micro-inserts and tubal occlusion. This test can be performed by hysterosalpingography (HSG), plain X-ray or ultrasound. Pregnancies reported after Essure sterilisation are, in a majority, related to non-adherence to the follow-up protocol or misreading of the confirmation test. A majority of the pregnancies occurred after HSGs that were determined to have been misinterpreted, including missed expulsion or perforation of the micro-insert. Other complications such as ectopic pregnancy and allergic reaction to the micro-inserts seem to have been described to be of low incidence.
authors.affiliation: Department of Obstetrics & Gynaecology, St Antonius Hospital, Nieuwegein, The Netherlands. Electronic address: s.veersema@antoniusziekenhuis.nl.
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Veersema
mesh_terms: D003267:Contraception / Q000379:methods*; D055356:Endometrial Ablation Techniques; D005187:Fallopian Tubes; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D010535:Laparoscopy; D010146:Pain; D011796:Quinacrine / Q000494:pharmacology; D012828:Silicones; D013245:Sterilization, Reproductive / Q000379:methods; D017211:Treatment Failure
chemical_list: D012828:Silicones; D011796:Quinacrine
keywords: adiana; confirmation test; essure; hysteroscopic sterilisation; ovabloc