Essure vs. Vasectomy

In My Humble Opinion
1

Long story short, my partner and I are in our mid-30s and don’t want kids.

I had assumed that I would take the lead and get the Essure procedure. Primarily because I feel that it would be easier to block the few (probably rotten) eggs I have left, than his trillions of sperm. I knew that the procedure to place the coils would probably be painful, since I haven’t ever given birth. I was willing to go through that. What I didn’t know was that a hysterosalpingogram is required to confirm success, and it is also often painful, and expensive. (Essure and vasectomy are both 100% covered by our insurance.)

My partner is willing to get a vasectomy. It seems a lot less complicated than the Essure procedure. And the confirmation test is simple, cheap, and relatively pleasant. :wink:

I’m looking for input. Has anyone else here had to make this choice before? How did you decide which procedure to choose? And if you have gone through the Essure procedure, I would like to hear about your experience, especially if you’re nulliparous.

Thanks!

2

I am not sure if this will be truly helpful, as I had a laparoscopic sterilisation with filshie clips, rather than the Essure procedure (this was 20 years ago). We talked about him or me, and went with me, for two reasons: because he had absolute panic attacks at the thought of hospitals/surgery (not specifically surgery on his scrotum, just needles/cuts etc); and it was weird, but I just I wanted to be absolutely sure I could never get pregnant, so I wanted to have the procedure.

3

It’s much easier to sterilize him as opposed to sterilizing you. That said, I’m 36, childless (by choice), and my husband and I have opted to go with the Mirena IUD (for now). I’m about 3 years through my second, now.

Insertion of the IUD isn’t much fun, to be sure, but it’s also quick and easy - one office visit to the gyn and you’re on your way. I was crampy for the next day, but other than that, was right as rain (so it’s an easier recovery than even his vasectomy). And it’s reversible in the (unlikely) event that we’ll change our minds.

We’ve tossed around the “what’s next” conversation, and it’s likely that he’ll get a vasectomy eventually. However, the Mirena might have some minor advantages for me as I get closer to menopause (the gyn said that its low dose of hormones might help with hot flashes and the like), and I’m like **Port Royal **in that I want to be absolutely certain of my own fertility (or lack thereof, as it were).

Good luck with your decision.

4

I have had Essure. My doctor had done over 300 of them, but I was the first nulliparous female he’d performed it on. It was painful, very unexpectedly painful. I basically climbed a wall, trying to get away from the doctor. I apparently didn’t make a sound, just reacted forcefully. They quickly sedated me, so I don’t remember anything else (I was a bit bummed, as I had wanted to watch them placing it on the screen). Afterwards, my doctor told me he would only perform the procedure on nulliparous women under sedation after that - the reaction of my cervix (and me) convinced him that it wouldn’t be worth trying it unsedated. I’m no cry baby either, I’ve had several surgeries before, and I have a reasonably high threshold for pain tolerance - at least of the sharp pain type.

The hysterosalpingogram wasn’t painful at all. It was uncomfortable, but not painful and was over with pretty quickly.
I agree that a vasectomy is easier than a tubal ligation, but I don’t agree that it’s easier than Essure. If you’ve got any questions, feel free to ask as I’m happy to answer, but at the end of the day only you two can weigh up the pros and cons and decide what to do :slight_smile:

Oh, and I also had a scratch test done prior to getting Essure, to check I had no intolerances to nickel (it was made from a nickel/titanium blend when I got it done) before I got it inserted.

5

I am waiting for this to get approval in the US. If it takes forever, I will go overseas to get it. But I prefer this over a vasectomy. It is cheaper, recovery is faster, has fewer side effects and is easy to reverse if I decide to do so.

http://techcitement.com/culture/the-best-birth-control-in-the-world-is-for-men/#.UP9a-x2_CgR

6

I missed the edit window. Another nice benefit of the procedure I posted is that it may prevent the spread of HIV by destroying sperm as they leave the body.

Supposedly there isn’t a lot of money in this procedure, so not a lot of interest here in the US.

7

Pardon me for asking, but is (for lack of a better term for it off the top of my head) female sterilization readily available for women who have not already had children?

8

A vascectomy is “easier” in that it’s generally done with the patient fully awake, so there are no anesthesia risks. Essure is sometimes (although not always) done with some level of sedation, which carries risks.

Essure is “easier” in that it uses holes that are already in your body to work through, instead of requiring a surgical incision.

Most women to get Essure are up and back to their normal activities within 24 hours, although they’ve generally got some crampiness and yucky feelingness. Most men after vasectomy need 2-3 days of kicking back on the couch with a bag of frozen peas on their crotch.

The risks of Essure are slight, but include perforation of the fallopian tubes or uterus, either during the procedure or in the weeks afterward as the scar tissue forms. This could require antibiotics or surgery. If your insertion is difficult, an x-ray of your uterus and fallopian tubes (hysterosalpingogram) should be done, as most early perforations do NOT show up on ultrasound. If the insertion was easy, they can just do an ultrasound to verify the correct placement. There are some procedures that cannot be done if you have Essure, like endometrial ablation, so if there’s a history of “female troubles” in your family, be sure your doctor knows about them before you decide Essure is right for you.

Risks of vasectomy are likewise slight, but include infection at the surgical site which could require antibiotics.

BOTH require a follow up appointment 3 months later to check if it worked okay, and another form of contraception needs to be used until that’s happened. Most of the time for both procedures, you’ll be good to go at 3 months, but sometimes with both procedures, you won’t be fully blocked, and will need to go back again in another 3 months (and keep using your alternate contraception.)

Neither, of course, protect against sexually transmitted infections.

The failure (read: pregnancy) rate is higher with vasectomy, but not by a whole lot.
Essure effectiveness:
99.83% at 5 years
(1.7 pregnancies per 1000 women)

Vasectomy effectiveness:
98.87% at 5 years
(11.3 pregnancies per 1000 women)
http://www.essure.com/is-essure-right-for-me/essure-vs-other-birth-control/essure-vs-vasectomy

Vasectomy can sometimes be reversed, Essure cannot. In reality, both should be considered permanent, though.

(This is not a comprehensive comparison, but what I can think of off the top of my head.)

9

Yes, I know all that. I have done my research and talked to my doctor.

I am really looking to talk to people who have made the choice about their decision-making process and their experiences.

10

Yes, thankfully.

11

IANAD, but I don’t think the sperm are the carriers of HIV (and other STDs).

12

I tell all my buddies that when they are done having kids, they need to man-up and get snipped (vasectomy). The sterilization procedure is far less invasive to the male than anything that would be done to the female. Getting snipped is easy and permanent (notwithstanding the stats upthread). I have to laff at guys who are afraid - it is not castration, and far less dizzying than the prospect of fathering a child unexpectedly.

Vasectomy involved shaving the surgical site (at home) Thursday night, surgeon appt Friday morning - local anasthetic at the surgeon, 15 min under the knife included a couple of tugs, some snipping, coterization, and stiches. Drive self home. Weekend at home laying around with a bag of frozen peas, back at work on Monday (desk job, not strenuous).

I forget the schedule, but needed to leave a couple of “samples” for the good doctor to check to ensure I was sterile before having unprotected sex. They also recommended a few sessions of “cleaning the pipes” during this time. I think I was given the all clear after a couple weeks.

13

We were making this choice. We wanted some form of BC that would be reliable in case I had to stop taking the pill at some point. But I was going to continue taking the pill in the meantime because I wanted the period control even if I had some other procedure done, so it didn’t make sense for me to get anything done. It was an easy decision away from it. My husband decided he wanted to control his own fertility, so he got the vasectomy. I don’t think it was a fun experience for him but he doesn’t seem traumatized by it, either.

14

Ah. I apologize. We looked at all that information and I went and got fitted for a Mirena. Which was so goddamn painful that the doctor couldn’t finish and gave me an inappropriate (for my medical history) prescription to fill and come back later. I left in tears and never went back. So we’re using a combination of FAM, outercourse, withdrawal and fervent prayer. Given the pain involved with the Mirena attempt, I don’t think I make a good candidate for Essure, sadly enough.

15

I love it when we show up to a thread together.

At any rate, what she said. It definitely was not traumatic. As she mentioned, the decision was a fairly easy one in our circumstances, and one I have had no cause to regret. I think I had more residual pain than most guys I’ve read about (based on other threads in this board), and I would still recommend the procedure for anyone contemplating it.

16

I noticed I really only answered the experience part, and skipped the decision-making part for me.
I have wanted to be sterilised pretty much since I found out that it could be done! When I was 22, I started researching seriously. I researched the different options, I researched possible side effects, I researched regret statistics. I then let it sit and marinate for six months. Researched again. Did a lot of thinking. Let it sit. Topped up the research. Let it sit again. After plenty of research and soul searching, I got it done at 24. The reason I spent two years thinking, researching and letting it marinate? Because every single place I turned, every person and resource was convinced I couldn’t know for sure and couldn’t do something so permanent at such a young age. As it turns out, I could! But I’m still happy I spent that time, so I could be sure. While you do change quite a lot as you get older, there are some things that are right at your core, that are essential to you - and this was one of those things for me.

Therefore, it wasn’t a vasectomy vs essure for me. I knew beyond a shadow of a doubt that it was what I needed to do and would’ve pursued it even if DH wanted a vasectomy. I chose essure over any other female procedure because it seemed the least invasive, certain aspects appealed to me and had the smallest failure rate.

17

This is my concern. I think it’s a lot easier for them to cut a couple little holes in the scrotum and snip the vas deferens than it is to cram a camera and a couple of springs up through my cervix. I know people who have had a vasectomy; they all describe it as no fun, but not a big deal. Most of the women I have heard from about Essure or IUD placement have described it as pretty awful or impossible.

18

Actually, they’ve changed that in the last year or so–my cousin had an ablation after Essure last summer. (I agree with her that it seems stupid to have to deal with a damn period when you’re already sterile.)

The cousin mentioned above said she had pretty much no pain with the ablation but very serious pain with the Essure. It apparently went off in a day or two, but it was apparently a pretty shitty day or two. She was shocked at how much it hurt; as she said, you’d think placing a little implant wouldn’t be nearly so bad as having tissue burned away.

19

Awesome! Thanks for the update. :slight_smile:

20

I chose to have a traditional tubal ligation, so I can’t speak to Essure, but I can tell you why we decided I would have the tubal instead of my husband having a vasectomy. It was because I knew 100% with absolutely no doubt that I never, ever wanted to be pregnant ever again. I wanted to know that no matter what, if I was raped, had an affair, divorced or was widowed (and started dating again) there was no chance whatsoever that I would end up pregnant. I was pretty young (32) and I had one son. I love him to the ends of the earth, but being pregnant was a nightmare and I never wanted it to happen again.