Last June I wrote about a FDA approved non-surgical sterilization procedure for women called Essure. Since then, I have learned of another: Adiana. Both have big benefits over getting a tubal ligation.
I had a chance to interview Dr. Schwartz, 
..doctor who has a good deal of experience in performing both procedures, and asked him to give me a comparison of the two.
What both procedures have in common
Both Essure and Adiana work by first putting an insert into the fallopian tubes. Then tissue grows around the insert to create a natural barrier so that eggs (oocytes) will not reach the beginning of the fallopian tube, and sperm won’t reach eggs.
Both procedures take very little time, don’t require anesthesia, and don’t require any incisions, as the inserts come in through the vaginal opening. Each requires a follow up visit 90 days after the procedure to ensure the tissue has grown; in the somewhat rare event it has not, the procedure can easily be done a second time.
Both have comparable failure rates: about 99% effectiveness.
Both are far more cost effective than a tubal ligation. Essure and Adiana cost about $3200. That is what the insurance company is billed, so given your coverage, the out of pocket cost will vary. They both can often be done in the doctor’s office, in which case there may only be a copayment. A tubal ligation typically costs about $15,000.
How they are different
The inserts are different. Essure’s insert is shaped like a coil, is made of stainless steel, polyethylene fibers and nickel titanium, and is about 3.6 centimeters long. The Adiana insert is shaped like a grain of rice, is made of pure silicon (not the kind of silicon that had been used in breast implants), is flexible and lubricous, and is .4 centimeters long.
The placement of the inserts is a bit different: the Adiana insert is placed 1.4 cm into the intramural portion of the fallopian tube (the part of the tube which is in the wall of the uterus). The Essure coil is placed 3.6 cm into the fallopian tube.
While both are made of materials that the body accepts, sometimes women have a reaction to the nickel, which would prevent them from doing the Essure procedure.
The size, placement and composition of the Essure insert can cause post-procedure discomfort, including cramping, and bleeding. The smaller size, placement and composition of the Adiana insert, however, make for no post-procedure discomfort.
Which to choose?
Although Essure had been on the market longer (Adiana was approved by the FDA in 2009 and Essure in 2002), Dr. Schwartz predicts Adiana will eventually take a larger share of the market. In his opinion, “..the Adiana device is easier to insert and better for the patient since no part of it protrudes into the uterine cavity or out into the fallopian tube” (which can create the post-procedure discomfort).
In a word, “Essure is good, but Adiana is better.” That is why Dr. Schwartz chooses to the Adiana procedure with his patients.
He is also a doc to put on the Ohio Doc Friendly list when it comes to sterilization! Thank you, Dr. Schwartz.
Anyone familiar with both procedures? Write in what you know!
This is great to know, Laura. The Adiana sounds like it would be a good choice for me. I haven’t approached my doctor about sterilization, but I keep wondering how much grief she’d give me (I’m under 30, married, no kids.) It seems so silly to me that a doctor could refuse to sterilize me on the grounds that I might change my mind later. People who choose to have kids aren’t prevented from doing so because they might regret it later. Isn’t that a form of discrimination?
Jennifer, I say if you are ready, check into docs in your area who do the Adiana procedure. Their website has this # to find docs in your area 888-352-9892.
If your doc happens to be one who does this procedure and gives you a hard time, I would not stand for it–find someone who understands it is not their place to make this decision for you! If my husband had not had a vasec I would be doing Adiana, I know that.
I loved that I was recommended for this procedure. My then husband refused to get snipped, but I was the one left taking care of our three kids and was scared about having surgery, when I heard I didn’t have to, I was relieved…. My youngest is 11 and no pregnancy since. No side effects, it was amazing. I’m grateful
Even though my husband has had a vasectomy, and has been tested sterile, I still worry about getting pregnant.
Before hubby’s snip, I was thinking about doing the Essure, and mentioned this to my Gyn – and she said that she would be more than happy to do it, if I/we decided that’s what was best for us. She gave me information on several forms of birth control, as well as a card of a urology clinic that she sends her patients to that are thinking about male sterilization. She also said something amazing – that she has been seeing a lot more women my age – married and unmarried – requesting sterilization.
It turned out that our insurance covered more on the vasectomy than female sterilization, and hubby gamely volunteered to go under the knife. He was pronounced sterile on VALENTINE’S DAY!!!(you need 2 tests, one a month after the vasectomy, and one a month after that – with the second negative test, you are deemed medically sterile). What a terrific gift. What more could a girl ask for? 😉
Audrey–interesting that your doc said that she is seeing a lot more women your age requesting sterilization…wish I could find har stats on this! I asked the doc who I intereviewed for this post and he could not point me to any real data on this. My theory is that it is a trend…more 20 something men and women being “early decider” as they have been called and taking care of birth control..permanently! In answer to what more could a girl ask for — yes, what a great val present! I would also anwer though–that female sterilization be covered equally as a vasecotomy :)!
Jennifer I can totally identify with you. I had mine done when I was 30, I always knew I wanted some form of permanent birth control and I have never been a mother. I waited until I was 30 and even so I discussed it with several doctors most of whom were against a permanent solution. The doctor who performed the procedure did not really encourage but was open to it. He said “I’m an options kind of person, I like to have more options in life rather than less but that being said I am here to provide you with medical information and services if you decide its right for you”. I liked that he was non judgemental about it whereas several providers before him and been very opinionated/judgemental/emotional and I could not understand why they felt they would know what was right for me and I would not.
That being said I did get the Adiana in January 2010 and have been very happy with it. I did have sedation during the procedure but I felt no pain afterwards and have not had any side affects. I was out of the office in about an hour and walking around. The three month checkup with the dye pinches but is very quick. My periods have been normal, I have not noticed any differences physically or mentally since having the procedure done. I think everyone needs to do their research but I wanted to leave my comment because not alot of people have had it done. I consider it a great option.
My wife had the Adiana procedure after our 5th child was born 6 month ago. Our doctors sold this idea to us letting us know that if she was not a candidate (not all women are) they would pass on letting us move forward. It seems that they felt it was Ok to move forward with the procedure and it was done. When my wife went back to get her tubes blown to test and see if it worked they found that one of the tubes were still wide open. The doctors made us wait 3 months saying that most likely she needed more time for scar tissue to form. We waited and went back today and got the dreaded news that she is still wide open and ready for my sperm in one of her tubes.
I can tell you this, it is not worth going through all of this if you are not going to get a 100% gaurantee that it will work. It is not fair that we were told if she was a candidate it was a slam dunk. I guess the biggest problem with this procedure is how do they really know if your a candidate?
My advise to anyone thinking about this, find a better way…. I now have to get a vasectomy!
Wow! Thanks for sharing this–I am going to pass your experience on to the doc I interviewed who seemed to favor Adiana..!
Hi, I had Adiana done on April 18th, 2012. I was put under for the procedure, so when I woke up I had a tiny bit of cramping, almost like I started my period went home and was back to normal after the anesthesia wore off. My doc had me do the depo shot 3 months before so my uterus lining thinned out. I go for a check up at the end of May to schedule HSG test. I have been reading a lot of reviews and feel very discourage. It seems not one women had good results with it.. I see where some got it done two years ago and were told they were 100% blocked but two years later are pregnant???? It’s very confusing. I have so many questions for my doctor. I can’t afford to get pregnant due to my heart condition. I just feel like this was a waste like I should of got my tubes tied. I really hope I can have a happy ending in July. Fingers crossed.
Does anyone knows how much adiana procedure would cost?
If my memory is serving me correctly about $2k–certainly no more than $5k — the website will have it I am sure adiana.com
I had the Adiana procedure in 2010 and got pregnant in 2013. My ababy is now one and I experienced the worst pregnancy of my life. I had to have a c section and they discovered my tube was ripped, attached to my ovary, and buried in adhesions. They had to dig my tube out asbo only had one to begin with. My Dr has no idea how I got pregnant. I had to have another surgery due to unknown pain and they found that all my organs were stuck together. After researching the clinical trials, Dr mishandling of the catheter can cause burning of the bowels. This is how my organs got stuck together. My stomach and liver will forever be one. This procedure was a joke and I should at the very least get my money back.
The only word to describe your experience is Unbelievable. Your story needs to be known to every woman who considers this procedure!
I also started a fb group called parents of unplanned Essure/ Adiana babies. We have almost140 members so far.
I had essure placed in april 2009. I had what i thought was no problems until i researched my heavy cycles and cramps. Then i was noticing my hair thinning out and my body covered in acne. Pelvic pain that wouldn’t go away. Then i started in about 2013, to have abdominal pains. Everything i eat, clean or not, makes me run to the loo. Got diagnosed with a variety of gi issues. When i researched my symptoms it was metal toxicity. I passed my hsg with flying colors. I told my gyn that looking at my past medical records, everything happened after essure. He denied it, offered me an ablation which i did . It was the worst mistake ever. Can’t wait to get mine out. I’m not the same woman i was before. I played by my highly trained essure doctor’s rules now is my turn to do what’s right finally for me. I’m not just another number, I’m real.
Wow…thanks so much for sharing your experience. I wonder if Adiana was still in business they would have not had these problems. They lost a suit with Essure, but many docs I talked to indicated they preferred Adiana to Essure…https://lauracarroll.com/what-happened-to-adiana/