Permanent, hormone-free birth control now available

The metal and polyester-fiber coil is inserted without surgery.

By JUDY SIEGEL-ITZKOVICH
birth control 298.88 (photo credit: courtesy)
birth control 298.88
(photo credit: courtesy)
Although a gynecologist at Hadassah-University Medical Center in Jerusalem's Ein Kerem is the only one in Israel trained to insert a special coil that permanently prevents conception without surgery, he does not want to keep the "revolutionary" technology to himself. "I think women have the right to choose it if they should not or do not want to have more children," says Dr. Ariel Revel. A uterine hysteroscopic expert who underwent training in the Netherlands, Revel has already treated 15 Israeli women with Essure, the safe permanent, non-hormonal birth control system approved by the Health Ministry last year. Only a gynecologist with expertise in hysteroscopy is permitted to do the insertion, said Revel, who will train doctors at Sheba Medical Center at Tel Hashomer and others in the North in the near future. The metal and polyester-fiber coil is inserted via the vagina into the opening of each of the two Fallopian tubes and remains there harmlessly and without side effects or pain for the rest of the woman's life. The technology replaces tubal ligation (tying of the Fallopian tubes), which until now was the only permanent birth control method but requires surgery under general anesthesia and at least a week's recovery. So far, after 80,000 women in the US, Europe and Australia underwent insertion of the coil since 2001, there hasn't been a single pregnancy (including ectopic - extrauterine - pregnancies). The Essure coil, made by the Concepta company in the US and Europe, was approved by the European health authorities in 2001 and the US Food and Drug Administration a year later. It is imported to Israel by MDSPharm, and Revel is so far the first to use it. The two pieces of coil cost 800 euros, while the tests, insertion and follow-up cost NIS 1,000, with a total cost of around NIS 6,000. As contraception products are not included in the basket of health services, these are paid for by the patient. It takes about eight minutes to insert it using a hysteroscope, which is an optic fiber about five millimeters in diameter that enables the gynecologist to see the uterine cavity and locate the opening of the Fallopian tubes facing it. The insertion is carried out in the clinic within eight minutes without opening the abdomen, scars or hospitalization and recovery is immediate. Its insertion causes the blockage of the tubes, thus it prevents the ripened ovum from being fertilized by sperm. When released in the tube, it takes on its form, and the polyester fibers promote the growth of tissue inside and outside the spring in a way that completely and permanently blocks entrance. This process takes about three months, during which women should use an additional means of contraception. The ova released by the ovaries each month are naturally destroyed by white blood cells. Revel told The Jerusalem Post that Essure does not affect menstrual periods or menopause, and because it causes a mechanical blockage and does not contain hormones, it does not cause changes in mood or weight gain. Modern Orthodox women who want to complete their childbearing so far constitute the main client group for Essure, said Revel, but haredi women who should not or do not want more children are also interested in it, he said, as there is no surgery. Men are not involved in the contraception and it takes effect gradually over three months rather than immediately.