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Understanding Transcervical Hysteroscopic Sterilization 

This procedure is a form of birth control. After it is done, you can no longer have children. You will be sterile.

But the FDA limited the use of the Essure transcervical hysteroscopic sterilization system for this procedure. Only healthcare providers who give specific patient education on the risks of the procedure are allowed to use this system. This limit was put into place because of many patient complaints.

During this procedure, your healthcare provider uses a tool called a hysteroscope. This long, thin tube has a camera and light on it. The camera sends pictures to a screen. It helps your healthcare provider see inside your womb (uterus).

Along with a hysteroscope, your healthcare provider uses a device loaded with small metal coils. The coils are called micro-inserts. They are made of nickel. They are placed inside your fallopian tubes, where they expand. The coils cause tissue to grow around and in them. This tissue slowly closes up the fallopian tubes over the next 3 months. Until then, you will need to use another reliable birth control method. This is because there is an increased risk for a tubal pregnancy. Then your eggs (ova) can no longer travel through the tubes to the uterus to be fertilized.

After the procedure, you will also need a test called a hysterosalpingogram to confirm that your fallopian tubes are totally blocked . 

Why transcervical hysteroscopic sterilization is done

You may choose to have this procedure if you no longer want to have children. It doesn’t call for surgery. Many women find it to be less painful than other choices for sterilization. You may also recover more quickly.

How transcervical hysteroscopic sterilization is done

This procedure is often done at an outpatient facility. You can go home shortly after it's done. During the procedure:

  • You are given medicine so you don’t feel any pain. It may also make you sleepy.

  • The healthcare provider puts a speculum into your vagina. It helps him or her see your cervix better.

  • The provider gently puts the hysteroscope into your vagina. It's moved into your uterus through your cervix.

  • The provider pumps saline solution into your uterus through the hysteroscope. It inflates your uterus. That helps the provider see the inside of your uterus better.

  • The provider finds your fallopian tubes using the pictures on the screen.

  • The provider puts the device with the metal coils into your uterus. The tip of this device is lined up with the opening of one of your fallopian tubes.

  • Once the device is in place, the provider presses a button on the device. The coils are released into the tube.

  • The provider checks that the coils are in the right spot.

  • The provider repeats these steps on the other fallopian tube.

Risks of transcervical hysteroscopic sterilization

  • Allergic reaction to the nickel coil

  • Autoimmune disorders

  • Bleeding

  • Need to remove the uterus (hysterectomy )

  • Infection

  • Movement of the coil. This can puncture an organ.

  • Pelvic pain

  • Pregnancy

  • Tear in the fallopian tube

  • Tear in the uterus

Online Medical Reviewer: Donna Freeborn PhD CNM FNP
Online Medical Reviewer: Heather Trevino
Online Medical Reviewer: Howard Goodman MD
Date Last Reviewed: 12/1/2019
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