ASK DR. H: Essure is a minimally invasive form of birth control

Q: I’m a 35-year-old mother not interested in having any more children. I don’t want to use an IUD or take birth control pills. My husband does not want to have a vasectomy. I saw my ob-gyn last week and she mentioned a new procedure called Essure that she says is much easier to do than a tubal [ligation] and can be done right in her office. I didn’t think to ask her how effective it is compared with a tubal [ligation]. Do you recommend the Essure procedure? — T.M., Marietta

A: Essure was approved by the Food and Drug Administration in late 2002 as a minimally invasive way of performing permanent, nonreversible female sterilization. Unlike a tubal ligation, it does not require general anesthesia and can be performed in your doctor’s office.

The technique is rather simple: Thin, flexible metal inserts are placed into the fallopian tubes using a catheter. Once these inserts are in place, they induce tissue to grow in and around the micro-insert to form a permanent barrier that will prevent sperm from reaching an egg.

Essure reports that complete occlusion can be expected in 96.5 percent of women at three months, with the remainder occluded by six months. Additional forms of birth control must be continued until success is confirmed.

In terms of its efficacy, the Essure procedure is 99.8 percent effective at four years post-procedure. That works out to a failure rate of 2 women per 1,000. In comparison, tubal ligation has a failure rate of 1 in 1,000.

Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Roswell, GA 30076. Because of the large volume of mail received, personal replies are not possible.