Fallopian Tube Implants

Definition
Purpose
Precautions
Description
Preparation
Aftercare
Risks

Definition

In the female reproductive tract there are two ovaries and two fallopian tubes. The fallopian tube is the path through which the egg passes after ovulation and potentially on the way to fertilization. If the fallopian tube is blocked, then the egg cannot pass through to become fertilized. One method of contraception is the use of fallopian tube implants. These are tiny metal springs that are placed in each fallopian tube. Scar tissue forms around these springs and blocks the transport of the egg through the fallopian tube.

Purpose

The purpose of fallopian tube implants is to create a permanent method of contraception. Many women who choose tubal implants for permanent contraception do so because they do not desire the side effects or risks of other methods of birth control.

Precautions

After tubal implant surgery another method of birth control needs to be used until it is confirmed that the fallopian tubes are in fact blocked, which is usually confirmed approximately three months after the fallopian tube implants are inserted.

Description

Fallopian tube implants are inserted without surgery. The procedure is done on an outpatient basis and does not usually take more than 30-60 minutes. During the procedure, the woman is placed in the same position as during a yearly pelvic exam. On occasion a physician may insert laminaria into the cervix several hours prior to the procedure, to gradually open the cervix. Laminaria are small sticks of dehydrated seaweed that slowly absorb moisture and gradually expand to open the cervix. If laminaria is not used prior to the procedure, then during the procedure, instruments are used to gradually open the cervix. A catheter is placed through the cervical opening and into the fallopian tube where the small metal spring is placed. This is repeated for the other fallopian tube. After the procedure an x ray is performed to make sure that both implants are properly placed.

Preparation

No special preparation for the procedure is needed. It is important, however, to make certain that the decision to have fallopian tube implants has been thoroughly discussed because this method of contraception is permanent.

Aftercare

After the procedure menstrual-like cramping may occur. As stated above, an x ray is performed after the procedure to make sure that the implants are properly placed. Approximately three months after the procedure, a follow-up visit should be planned. During this follow-up visit, a hysterosalpingogram will be performed. For a hysterosalpingogram, dye is injected into the uterus as the physician watches on the x ray to see if the dye is able to flow through the fallopian tubes. If the fallopian tube implants work, then the dye will be stopped in each fallopian tube, showing that the tubes have been blocked. On occasion, fallopian tube implants may be difficult to insert, or the hysterosalpingogram shows that the implant did not block the fallopian tube, in which case, the fallopian tube implant procedure would need to be repeated. Until it is verified that the fallopian tubes are blocked, another method of birth control needs to be used.

Risks

Fallopian tube implants are a new method of birth control that became available in 2002, therefore, there are no long-term statistics available on how effective they are at preventing pregnancy. Other methods of tubal contraception are not 100% effective at preventing pregnancy. There has been one reported confirmation of a pregnancy after a tubal implant and after confirmation by hysterosalpingram that the fallopian tube were blocked. If a tubal implant fails, there is an increased risk for ectopic pregnancy. An ectopic pregnancy occurs when the fertilized egg implants in the fallopian tube or in a place other than the uterus. Fallopian tube implants do not affect the menstrual cycle, and therefore, if a woman misses her menstrual period, or has other symptoms of pregnancy, she should contact her physician immediately.

Resources

BOOKS

Caughey, Aaron B., Arzou Ahsan, et al. Blueprints Obstetries and Gynecology, 4th edition: Lippincott, Williams and Wilkins, 2006.

PERIODICALS

Ory, E. M., Hines, R. S., Cleland, W. H., Rehberg, J. F. “Pregnancy after microinsert sterilization with tubal occlusion confirmed by hysterosalpingogram.” Obstetrics and Gynecology. 111 (2 PT 2) (2008): 508–510.

Wittmer, M. H., Famuyide, A. O., Creeden, D. J., Hartman, R. P. Hysterosalpingography for assessing efficacy of Essure microinsert permanent birth control device.” American Journal of Roentgenology 187, no. 4 (2006): 955–958.

ORGANIZATIONS

Our Bodies Ourselves Health Resource Center, 34 Plympton Street, Boston, MA 02118. (617) 451-3666. http://www.ourbodiesourselves.org/.

Renee Laux, M.S.

Fallopian tube ligation seeTubal ligation

Fallopian tube removal seeSalpingostomy