New Wave Birth Control

"I am NOT going to want to have any children. I'm not cut out to be a parent"

"Due to health issues, my primary doctor has advised me not to become pregnant."

Does this sounds like you? Then your next thought might be: "What are my options?"

Until recently there were two: Women could have a tubal ligation or their partners could have a vasectomy. Both are invasive, surgical procedures.

According to WebMD.com, tubal ligation has a 9 percent failure rate. This means that every year 9 out of 100 women who have undergone this form of "permanent" birth control find themselves expecting a baby.

Vasectomy does fair better, with an efficacy rate at 99.7 percent.

Both procedures need to be done in an operating/surgical room, require recuperation time and can cost anywhere between $2,500 to $10,000. Both can cause the patient a significant amount of discomfort.

Now there is another option, a new procedure called Essure Permanent Birth Control, which has been developed by Conceptus, Inc.

Basically, it is a non-invasive technique for all women who want and/or need a permanent form of birth control. Medi-cal has approved it for women who are over 21 and are beneficiaries of Medicaid. Because it is done in a typical examining room, Essure may only cost $1,500-$2000.

To find out more about Essure, we spoke with Dr. David Plourd, who trained at the UC Irvine Medical Center and is an assistant professor of obstetrics/gynecology at the Naval Medical Center in San Diego, both in California and with Dr. Jonathan Wheeler, who is an attending physician at Hoag Memorial Hospital in Newport Beach, California and has served as a past chairman of the department of obstetrics/gynecology.

The doctors were among the first trained by Conceptus, Inc. They believe that once the public is fully informed that this will probably be "the wave of the future" in permanent birth control. Unlike tubal ligation and vasectomy, however, there is absolutely no way to reverse this procedure, the doctors said.

Q. What is Essure and how does it differ from tubal ligation?

Plourd: Essure is a titanium metal coil. These coils are inserted through the vagina and into the fallopian tubes without the use of anesthesia. These coils cause a blockage which goes on to develop scar tissue, making it impossible for the patient to become pregnant.

Wheeler: In a way, this part is similar to a male vasectomy. Like that procedure, a secondary form of birth control must be used for about three months - the essential time it takes for enough scar tissue to form in the tube and around the coil creating a permanent barrier. The FDA has issued a requirement that the patient must have a "dye" test performed to be sure that the tubes are definitely completely blocked and then the backup method the patient has been using may cease.

Q. Is there a downside?

Plourd: From my standpoint, the only downside would be that the patient has to be very, very sure that they do not wish to become pregnant. There is very little discomfort, no anesthesia, and the cost is significantly lower since there is no need for an operating room.

Wheeler: There are no incisions. Many of my patients drive themselves home right after they are through in my office. The only time this would differ is if there is some form of unforeseen problem during the initial exam where the fallopian tube itself has a blockage. In this rare instance we abort the procedure and schedule a diagnostic test to check out the patency of the tubes. This isn't done ahead of time due to costs and inconvenience - as well as the rarity of the situation.

Q. Is Essure the only product like this out there?

Wheeler: At this time, yes. But there are other similar products that will add to the choices women have for reliable and safe methods of totally permanent birth control very soon.

Plourd: At this point, I certainly agree. There are two companies that are nearing completion of their own versions. Adiana is literally waiting for its final approval. It will combine electrical stimulation with the scarring of the fallopian tubes. There is also Ovion, which has been in the midst of its clinical trials since 2006.

Wheeler: One last piece of interesting data for your readers: There is numerous data that has been collected and is still being gathered showing that this method of tubal occlusion may reduce endometriosis and possibly ovarian cancer, thus yielding an additional amount of medical benefits to women and cost-cutting to hospitals.