Correct placement of the Essure device detected by transvaginal ultrasound at one month predicts correct placement at three months

Sarah Mitchell, James May, Alex Ades


Background: Correct placement and tubal occlusion following Essure sterilisation is presently confirmed with imaging 3 months post procedure.  Compliance with post procedure imaging is low and non-compliance has been implicated in unintended pregnancies following Essure insertion.  Patient adherence to medical advice is known to decrease with time.  Earlier imaging may improve compliance. The Aim was to determine if correct placement of the Essure micro-insert detected at 1 month by transvaginal ultrasound (TV US) is predictive of correct placement at 3 months.

Methods: Prospective cohort of 31 patients in a single centre who underwent the Essure procedure and had TV US at 1 month and 3 months post procedure.

Results: The Essure micro-insert was detected in the accurate position by TV US in all 31 women at both 1 month and 3 months post insertion.

Conclusions: Correct placement of the micro-insert detected at 1 month is predictive of correct placement at 3 months.  TV US at any time from 1 month could be used as the confirmation test for correct placement of the Essure device.  This may provide earlier reassurance to women and improve compliance with follow up potentially reducing numbers of unintended pregnancies. The importance of alternative contraception until 3 months post insertion should still be emphasised.


Essure, Ultrasound, Contraception, Hysteroscopic sterilisation

Full Text:



Ariona Je, Miño M, Cordón J, Povendano B, Pelegrin B, Castelo-Branco C. Satisfaction and tolerance with office hysteroscopic tubal sterilisation. Fertil Steril. 2008;90:1182-6.

Wortman M, Daggett A, Ball C. Operative hysteroscopy in an office-based surgical setting: review of patient safety and satisfaction in 414 cases. J Minim Invasive Gynecol. 2013;20:56-63.

Valle RF, Carignan CS, Wright TC. Tissue response to the STOP microcoil transcervical permanent contraceptive device: results from a prehysterectomy study. Fertil Steril. 2001;76:974-80.

Theil J, Suchet I, Tyson N, Price P. Outcomes in the ultrasound follow-up of the Essure micro-insert: complications and proper placement. J Obstet Gynaecol Can. 2011;33:134-8.

Verseema S, Vleugels M, Koks C, Thurkow A, van der Vaart H, Brölmann H. Confirmation of Essure placement using transvaginal ultrasound. J Minim Invasive Gynecol. 2011;18:164-8.

Weston G, Bowditch J. Office ultrasound should be the first-line investigation for confirmation of correct Essure placement. Aust N Z J Obstet Gynaecol. 2005;45:312-5.

Kerin JF, Levy BS. Ultrasound: an effective method for localisation of echogenic Essure sterilisation micro-insert: correlation with radiologic evaluations. J Minim Invasive Gynecol. 2005;12:50-4.

Chapa, HO, Bakker K, Sandate J, Silver L, Antonetti AG. Essure sterilisation with sonographic confirmation test: protocol description and clinical outcomes using ultrasound as an Essure confirmation test. J Gynecol Surg. 2011;27:57-62.

Connor V. Contrast infusion sonography in the post-Essure setting. J Minim Invasive Gynecol. 2008;15:56-61.

Jost S, Huchon C, Legendre G, Letohic A, Fernandez H, Panel P. Essure(®) permanent birth control effectiveness: a seven-year survey. Eur J Obstet Gynecol Reprod Biol. 2013Jun;168:134-7.

Veersema S, Vleugels MP, Moolenaar LM, Janssen CA, Brölmann HA Unintended pregnancies after Essure sterilization in the Netherlands. Fertil Steril. 2010;93:35-8.

Shavell VI, Abdallah ME, Diamond MP, Kmak DC, Berman JM. Post-Essure hysterosalpingography compliance in a clinic population. J Minim Invasive Gynecol. 2008;15:431-4.

Soutter WP, Moss B, Perryman K, Kyrgiou M, Papakonstantinou K, Ghaem-Maghami S. Long-term compliance with follow-up after treatment for cervical intra-epithelial neoplasia. Acta Obstet Gynecol Scand. 2012Sep;91:1103-8.

Benner JS, Glynn RJ, Mogun H, Neumann PJ, Weinstein MC, Avorn J. Long-term persistence in use of statin therapy in elderly patients. JAMA. 2002Jul24-31;288:455-61.

Teoh M, Meagher S, Kovacs G. Ultrasound detection of the Essure permanent birth control device: a case series. Aust N Z Obstet Gynaecol. 2003;43:378-80.

National Health and Medical Research Council. National Statement of Ethical Conduct in Human Research. The National Health and Medical Research Council, the Australian Research Council and the Australian Vice-Chancellors’ Committee. Commonwealth of Australia, Canberra. 2007 Available at: Accessed May 2013.