Essure & Surrogacy: The Fertility Experts Weigh In

Essure and Surrogacy: The Fertility Doctors Weigh In

Essure isn’t for everyone. We learned this recently as Corinne shared her personal story with us. So this got me thinking, what is Essure exactly, and if it’s so bad, why is it still being used? Questions needed to be answered, and I was determined to find out more information to share with you all.

I wrote emails a handful fertility clinics with my questions. Within the following few days I’d received a few short, to the point replies, and one phone call directly from a local Reproductive Endocrinologist.

Dr. Michael Murray with Northern California Fertility Medical Center, or rather, NCFMC, spent a good amount of time on the phone with me to discuss everything Essure and surrogacy. We have him to thank for this insight into the world of essure and the impact it has on your fertility.

So, what exactly is Essure? 

Essure is a permanent form of birth control, without releasing hormones, or requiring incisions, where two small coils are inserted into the fallopian tubes. Once in place, your body will create scar tissue surrounding the coils, which will build up to block the fallopian tubes completely. While the scar tissue builds a back-up method of birth control will be needed.

Essure sounds a lot like a tubal ligation, doesn’t it? Not so fast…

Yes, both Essure and tubal ligation procedures essentially have the same outcome. Yet unlike the well-known tubal ligation procedure – where the woman’s fallopian tubes are cut, cauterized, and tied – the Essure coils poke outside the fallopian tubes and protrude into the uterus. This is potentially dangerous for pregnancy; as the uterus grows, the coils can poke into and rupture the embryonic sac.

So, a woman who has had a tubal ligation, or her “tubes tied”, is fully capable of being cleared to carry a pregnancy as a gestational surrogate. This is not the case with Essure.

In the words of Dr. Collin Smikle, of Laurel Fertility Care:

“The reason that Essure was used in the first place for contraception is that it is very effective in blocking the portion of the tubes as they leave the endometrial cavity. During the insertion, a tail is left that trails into the cavity and acts as a wick for the granulation tissue to generate and close the proximal portion of the tube.  This tail persists after the granulation is complete and can be seen for years afterwards.  Patients who have gotten pregnant with the device in may have premature rupture of the membranes or early loss due to the string.

Therefore, it isn’t that someone with the Essure device can’t be a surrogate. However, it does mean that she may need to undergo a procedure to make sure that there isn’t any tail protruding into the cavity to cause any disruption of implantation.  Many programs would rather not tolerate the risk so would not select a surrogate with one in.”

Unfortunately, Corinne was told by medical professionals that Essure was perfectly safe for surrogacy, and went ahead with the procedure. Of course you’re going to trust the opinions of your doctor, right? Well, in Corinne’s case, wrong. Only she didn’t find that out until she was matched with a new couple and ready to begin a second surrogacy journey with them. After meeting and feeling a wonderful connection, she was denied by their RE due to the Essure. Can you imagine the heartbreak they all went through?!

So while Essure is not beneficial for those pursuing surrogacy, I did learn a few piece of information about Essure and IVF from speaking with Dr. Murray:

  • There are a few scenarios in which doctors will suggest Essure to their IVF patients, in which to achieve a pregnancy, such as known pelvic adhesive disease.
  • Women can successfully carry a pregnancy with Essure in place, though it may decrease the live birth rates, and requires continual monitoring.
  • A procedure can be done to the Essure coils to trim them down, to give the pregnancy the best chance.
  • If a family member or friend was acting as the surrogate, altruistically, and had Essure in place, she could be cleared by the clinic. Otherwise, the pregnancy is just too risky.

Dr. Murray’s Advice:

If you are done having your own children, but would be interested in becoming a surrogate, your best bet for permanent sterilization is to have a tubal ligation.

Thank you to Dr. Murray and Dr. Smikle for their insight into Essure and Surrogacy!