Authors' recommendations: Based on current evidence, HTS using the Essure® system can be an alternative to LTS in women with visualization of both tubal ostia and the anatomical possibility to place the micro-inserts. At relatively short follow-up periods the intervention seems to be adequate in terms of safety and effectiveness, with few reported failures or cases of major adverse events. One important disadvantage of the intervention is its irreversibility and the potential of regret downstream in younger women. The intervention prevents pregnancies at at least the same level as do the traditional methods available for female sterilization. However, the nature of the tissue, the cellular and fibrotic response, and the ability of the tissue to maintain occlusion of the fallopian tubes are not known for longer periods of time. This is more important if the Essure® system is provided to younger women who need to rely on permanent fertility control throughout their reproductive years. Good communication and compliance with the protocol by professionals and women are important factors that impact the success of the intervention. The Essure® system has the advantages of avoiding surgical incisions and general anesthesia, and of promising a faster recovery time. The hysteroscopic approach could probably be a clear indication in women with a relative contraindication to laparoscopy due to morbid obesity, intra-abdominal adhesions, or cardiopulmonary diseases, or those with contraindications for general anesthesia. Several sterilization options are available to couples and these options need to be compared, over the longer term, to the Essure® system, using a risk/benefit approach. Appropriate education and counseling are key, due to the irreversibility of the Essure® system.

Project Status: Completed

Year Published: 2014

URL for published report: http://www.ihe.ca/advanced-search/hysteroscopic-tubal-sterilization

URL for additional information: http://www.health.alberta.ca/initiatives/health-evidence-reviews-list.html

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute of Health Economics

Contact Address: 1200, 10405 – Jasper Avenue, Edmonton, AB T5J 3N4, Canada. Tel: +1 780 448 4881 Fax: +1 780 448 0018

Contact Name: info@ihe.ca

Contact Email: info@ihe.ca

Copyright: Institute of Health Economics (IHE)