Remedies & Therapies > Reproductive

Tubal Ligation: The Pros & Cons of Getting Your Tubes Tied

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mommyjen:
mykidsmom, have you considered NFP?  It works when you use ALL three signs (temp, cervix, & cervical fluid).  The user success rate is 99% and that's about as good as it gets, not considering permanent surgery.  I would be wary about the essure, though I don't know much about it. First, it's new and i'm not one to be a guinea pig.  Second, I don't believe anything they would say regarding "safety", unless it has been clinically proven by a third party.  Women have been getting tubals for years without informed consent.  Most women do not know about PTS, post tubal syndrome.  I have had several aunts who thought that their debiliating cycles that led to hysterectomies were just a part of aging.  Um, no.  It's due to their tubal.  Don't even get me started about the lack of informed consent regarding hysterctomies.  Irritates me to no end.  The safest course in my mind would be to let a generation of women go by before considering essure.  That's often enough time to tell.


--- Quote ---Essure is one of the newest methods of permanent birth control, so it has not been studied in as many women or for as long as most birth control methods. Over 600 clinical study participants have relied on Essure for contraception for 1 year, and approximately 200 of them have relied on Essure for 2 years. There are very little data on the safety of or the chance of pregnancy with Essure beyond this time frame. Once longer-term data are available, the information on the safety of and chance of getting pregnant while using Essure may be different than the data based on 1 or 2 years of use.

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--- Quote ---You should be aware of these risks and discuss them in detail with your doctor before you make your decision. Some of the risks associated with Essure have already been discussed above, but additional risks, such as pain and bleeding following the Essure placement procedure as well as risks associated with future medical procedures that you may undergo after your Essure placement procedure, are discussed in the Risks section at the end of this booklet. Please read the Risks section at the end of this booklet carefully. In addition to the risks previously discussed, other risks and considerations are also discussed. Some of the risks discussed in this booklet were experienced by women in the clinical studies of Essure. Some of the risks were not among those reported during the clinical trials, but should still be considered as potential risks of Essure. You should talk to your doctor about the likelihood of these risks, particularly in relation to your own situation.
--- End quote ---


--- Quote ---Failure to place 1 or both of the Essure™ micro-inserts in the correct location or to obtain tubal occlusion by 3 months after the procedure

 
In the clinical studies, approximately 1 out of every 7 women were not able to have the microinserts placed in both fallopian tubes during the first placement procedure. At routine 3-month follow-up, 4% of the women who did receive placement in both tubes were found to have micro-inserts in the incorrect position. The types of incorrect positions included:

 
The micro-insert(s) was (were) too far or not far enough into the tube

The micro-insert(s) had been poked through the wall of the fallopian tube or uterus (perforation)

The micro-insert(s) had come out of the body (expulsion)

The micro-insert(s) was (were) in the body, but outside the fallopian tube


 
As a result of the above-listed incorrect positions of the micro-insert(s), these women could not initially rely on the Essure micro-inserts for birth control. Some of the women whose micro-inserts had come out of their bodies decided to undergo a second placement procedure and were then able to rely on the Essure micro-inserts for birth control. Approximately 3.5% of women did not have occlusion of both fallopian tubes at the HSG performed 3 months after the procedure. All of the women, however, did have occlusion of both fallopian tubes at a second HSG performed approximately 6 months after the procedure.

 
Other complications that can occur during the Essure placement procedure and postprocedure recovery

 
Pain/vaginal bleeding. Most women in the clinical studies reported mild to moderate pain during the Essure micro-insert placement procedure. Many women reported mild to moderate pain and/or cramping and vaginal bleeding for a few days following the procedure

Nausea/vomiting/fainting. Some women in the clinical studies reported nausea and/or vomiting or fainting following the procedure

Overabsorption of fluid. Rarely, women in the clinical studies absorbed too much of the fluid used to expand the uterus during the placement procedure. This can result in shortness of breath or the need for medication to get rid of the excess fluid. If this condition is not treated by your doctor immediately, serious complications can occur, including death

Broken Essure micro-insert. Rarely in the clinical studies, a portion of the Essure micro-insert was broken off during the placement procedure. This occurrence has not been reported to have caused a problem in preventing pregnancy or to have resulted in pain or other problems

Undiagnosed pregnancy at time of Essure placement procedure. Women who undergo the Essure placement procedure, or any other sterilization procedure, during the second half of their menstrual cycle (after ovulation) are at an increased risk of unknowingly being pregnant at the time of the placement procedure. Therefore, the micro-insert placement procedure should be scheduled during the first half of the menstrual cycle, before ovulation occurs. On rare occasions during the clinical studies, when the Essure procedure was performed in the second half of the menstrual cycle, the women in whom the procedure was performed were unknowingly pregnant at the time of the procedure. The effects of the micro-inserts on you or the developing fetus are not known

Anesthesia risks. There are risks associated with the anesthesia (medicine to control sensation or consciousness) used during the Essure placement procedure. You should discuss with your doctor the risks of the particular anesthesia method recommended for you

Infection. You should contact your doctor if you have fever, vaginal discharge or odor, or severe pain following the procedure


 
Complications that may occur after the Essure™ placement procedure

 
Pregnancy. No method of birth control is 100% effective, so pregnancy can occur even with a permanent birth control procedure such as Essure. Essure has been demonstrated in clinical studies to be 99.8% effective at 2 years of follow-up

Ectopic pregnancy. Ectopic pregnancy is when the pregnancy occurs outside of the uterus (womb), usually in one of the fallopian tubes. While this did not occur in the clinical studies, it is still possible with the Essure procedure. Women who undergo sterilization, by Essure or incisional tubal ligation, are more likely to have an ectopic pregnancy if they get pregnant. If your period is more than 5 days late, or you suspect for any reason that you might be pregnant, call your doctor immediately so that you can be tested for pregnancy and monitored for the possibility of ectopic pregnancy. Ectopic pregnancy can be life threatening if not treated

Risks to mother/fetus if you become pregnant. If you do become pregnant, the risk of the Essure micro-inserts to you, the continuation of the pregnancy, the fetus, childbirth, or a pregnancy termination procedure (abortion) are unknown

Changes in menstrual cycle (period). Some women in the clinical studies reported temporary changes in their periods; however, very few women reported permanent changes. These temporary/permanent changes included the following:
—periods that were heavier or longer than normal
—bleeding or spotting between periods

Pelvic/back/abdominal pain. Some women in the clinical studies reported 1 or more episodes of pelvic, back, or abdominal pain. Very few women reported persistent pain

Regret. As with any major decision, there is the risk that you will regret your decision to end your fertility. The risk is much greater for younger women

Pelvic inflammatory disease. If an infection occurs, there is the potential for pelvic inflammatory disease. This was not reported during the clinical trials

Risks of hysterosalpingogram (HSG)/X ray. There are risks associated with the HSG that is performed before you can rely on Essure for contraception. You should discuss these risks with your doctor

Risks of future medical procedures. In the future, you may be offered or require medical procedures that involve the uterus or fallopian tubes. The safety and effectiveness of these procedures, such as those identified below, in women who have the Essure micro-inserts are not known. In addition, such procedures could interrupt the ability of the Essure micro-inserts to prevent pregnancy. Whenever you have any medical procedure or see a new doctor, tell the doctor that you have this device.

Some of the procedures that can involve possible risks are:

—dilation and curettage of the uterus (D&C) or endometrial biopsy, because these methods may snag the portion of the micro-insert that is in the uterus

—hysteroscopy or endometrial ablation, because these methods sometimes use electrical energy, which may heat the micro-inserts and cause tissue damage

—in vitro fertilization (IVF), because this method may snag the portion of the micro-insert that is in the uterus or the micro-inserts may interfere with successful implantation of the fertilized egg. There are no data on the safety or effectiveness of IVF with Essure. If pregnancy is achieved, the risks of the micro-inserts to your health, the continuation of the pregnancy, the fetus, or childbirth are unknown

Magnetic resonance imaging (MRI). The Essure micro-inserts were found to be safe at a high MRI field strength. However, when undergoing MRI, the presence of the micro-inserts can produce an obscure image of tissue at or near the micro-inserts. Whenever you have a medical procedure or see a new doctor, tell the doctor that you have this device and show your patient identification card to your doctor
 

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http://www.centerforwomen.com/MainFrames/essured.htm

mykidsmom:
Thanks for the info.  I researched the Essure more after posting late last night and decided "no way."  I went looking for women who had problems with it and there were too many cases of "this was the worst mistake of my life" for me to be comfortable with it. 

I like NFP but my husband does not.  Partly because he believes if he's the one that doesn't want more kids then he should be the one to be in charge of the BC.  I actually really respect that.  Especially because I'm more in the the line of "letting God choose my family size."  He's just not real keen on a vas. but I think we will end up having no other choice if he doesn't want to use NFP.

Thanks for the input.

patti

cobalt6haze:
I have had major problems since having a tubal after our 6th baby. All of the doctor's that have been to won't even listen after I tell them I have 6 kids. They instantly say it's because I have so many kids or I'm stressed. And believe me I 've been checked from head to toe and they can't find anything wrong with me.  But, I did not have even one of these problems after having 5 babies and that's alot of babies and stressful. I've had digestion problems, migraines(never had before), crazy PMS, weird periods that start and stop for about two weeks, terrible cramps, anxiety and depression, NO libido, my hair fell out so badly that you could see my scalp through my hair, sleep disturbances, joint pain,skin problems ,and brain fog. It's just like what my mother had during perimenopause. I had none of this before my tubal. But, guess what, I had this tubal after my husbands vasectomy that he got while I was pregnant with #5, failed. He now has severe prostate enlargment and pain. Like he would if he were 70. We are both only 29. His problems started about a year after his vasectomy. I am having a reversal in about three weeks, I will post if it helps relieve any of thes symptoms. We plan to use NFP with an ovulation moniter after the procedure. Honestly, I would much rather have more babies than deal with crazy half functioning health. We'll just have to focus on our hobbies for a week out of the month:)

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