Essure is a permanent transcervical sterilization procedure for women developed by Conceptus Inc. It was approved for use in the United States on November 4, 2002.^[1]

Two economic studies, one of which implemented Essure as an in-office procedure, suggest that Essure could be more cost-effective than laparoscopic bilateral tubal ligation.^[2]

Procedure[link]

Inserts are placed into the fallopian tubes by a catheter passed from the vagina through the cervix and uterus. The insert contains inner polyethylene terephthalate fibers to induce benign fibrotic reaction and is held in place by flexible stainless steel inner coil and a dynamic outer nickel titanium alloy coil.^[3] Once in place, the device is designed to elicit tissue growth in and around the insert to form over a period of three months an occlusion or blockage in the fallopian tubes; the tissue barrier formed prevents sperm from reaching an egg.

Unlike other forms of tubal ligation, no general anaesthetic nor incision through the abdomen is required.

Similar to some other methods of birth control, initially additional forms of birth control must be continued for 3 months^[2] to prevent pregnancy until the method's effectiveness can be confirmed.

Follow-up[link]

For the Essure method, three months after insertion a physician performs an x-ray test called a hysterosalpingogram^[4] to confirm that the fallopian tubes are completely blocked and that the patient can rely on the Essure inserts for birth control.^[1] A contrast agent (dye) is injected through the cervix, and an x-ray technologist takes photos of the Essure coils to ensure that they are in place.

Efficacy[link]

Following successful insertion and occlusional response, the Essure procedure is 99.74% effective based on 5 years of follow-up, with zero pregnancies reported in clinical trials.^[5][6]

The reported insertional failure rates are "failure to place 2 inserts in the first procedure (5%), initial tubal patency (3.5%), expulsion (2.2%), perforation (1.8%), or other unsatisfactory device location (0.6%)".^[7] Upon follow-up, occlusion is observed to have occurred in 96.5% of patients at 3 months with the remainder occluded by 6 months.^[1]

Cautions and warnings[link]

The inserts do not prevent the transmission of sexually transmitted diseases. The procedure takes about 10 minutes^[8] for a trained physician to perform and can be performed in a physician's office. General anesthesia is not required. Unlike many temporary methods of birth control, the Essure inserts do not contain or release hormones.

The inserts are made from polyester fibers, nickel-titanium and stainless steel and are safe to use with MRI equipment. The Essure procedure is reported to be permanent and not reversible by the manufacturing company. Notwithstanding the manufacturer's position, several Essure reversals have been performed.^[9]

Additional birth control must be used for three months after procedure.^[7][10]

Risks[link]

• Perforation, expulsion, or other unsatisfactory location of the insert
• Pregnancy and increased risk of ectopic pregnancy
• Pain, cramping, vaginal bleeding, menstrual pattern changes, light periods at first then longer, heavier periods lasting up to 6–8 weeks due to changing birth control methods to a non-hormonal solution
• Nausea/vomiting
• Vasovagal response (fainting)
• Allergic reaction to the materials

References[link]

External links[link]

• Official website

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Trista Nicole Sutter (née Rehn) (born October 28, 1972 in Indianapolis, Indiana)^{[citation needed]} was the runner-up on season 1 of the ABC reality television show The Bachelor, before becoming the star of the first season of its companion show The Bachelorette.

Trista has also appeared on ABC's Dancing with the Stars and NBC's Fear Factor.

[edit] The Bachelor

Trista appeared as a contestant on season 1 of ABC's The Bachelor. She finished runner-up after bachelor Alex Michel selected Amanda Marsh as the winner ahead of Trista in the show's finale.^[1]

[edit] The Bachelorette

After her appearance on The Bachelor, Trista was selected to be featured in the gender-reversed spin-off The Bachelorette. She chose Ryan Sutter as the winner, and the couple were married on December 6, 2003. They were paid US$1 million by ABC^[2] for affording the network the right to televise their wedding ceremony, which was broadcast as the finale of a three-episode special called Trista & Ryan's Wedding, which drew over 26 million viewers, making it one of the most-widely viewed episodes in the history of reality television.^{[citation needed]}

Television appearances[link]

Under her birth name, Rehn was a Miami Heat cheerleader in the early 2000s.

Trista appeared opposite actor Jason Alexander in a KFC commercial. She also has appeared in country music singer Brad Paisley's music video "Celebrity" in 2003 with Alexander, Little Jimmy Dickens, and William Shatner.

She was the first celebrity contestant to be voted off season one of the television show Dancing with the Stars.

On June 10, 2011 Trista and Ryan Sutter appeared in a Hands Only CPR PSA campaign from the American Heart Association and the Ad Council.^[3]

Personal life[link]

The Sutters now live in Eagle County, Colorado,^{[citation needed]} where Ryan is a firefighter in Vail, Colorado.

In February 2007, the Sutters told People magazine that they were expecting their first child in summer of 2007. During her seventh month of pregnancy, Trista was diagnosed with gestational diabetes. In July 2007, Maxwell Alston was born four weeks early stemming from pregnancy complications via c-section after a failed induction/stalled labor. Maxwell was first revealed to the public on the cover of Us Weekly magazine^[4] and made his first on-camera appearance in a video diary series Trista recorded for Momlogic.com.^[5]

Trista was ranked #7 on the Maxim Hot 100 Women of 2003.^[6]

On October 14, 2008, Trista and Ryan announced to Life and Style magazine that she was pregnant with their second child. Trista said that if the baby was another boy, they might adopt a girl.^[7] In April 2009, Trista delivered daughter Blakesley Grace via C-section.^[8] In April 2009, she also confirmed that she plans to undergo the Essure permanent birth control procedure.^[9]

References[link]

External links[link]

• Trista Sutter at the Internet Movie Database
• Trista Rehn profile at NNDB