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AdianaBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/adiana/MY01093
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The Adiana system is a type of permanent birth control for women. The Adiana system includes two small silicone pieces that are placed in the fallopian tubes. They're inserted through the vagina, so no incision is required. During the procedure, your health care provider heats a small portion of each fallopian tube and then inserts a tiny piece of silicone into each tube.
After the procedure, scar tissue forms around the silicone inserts, blocking off the fallopian tubes and preventing sperm from reaching the egg. It takes time for this to happen. So you must use another form of birth control for the first three months.
Why it's done
The Adiana system is a type of female sterilization. Benefits of the Adiana system include:
- Lack of significant long-term side effects
- No need to buy contraception, interrupt sex for contraception or seek partner compliance
- No incision
- Convenience — the Adiana system can be implanted at your health care provider's office
- No effect on your menstrual cycle
The Adiana system isn't appropriate for everyone, however. Your health care provider may discourage you from choosing the Adiana system if you:
- Are allergic to the contrast agent used to confirm tubal blockage
- Are taking medications that suppress your immune system
- Have an external pacemaker or internal cardioverter defibrillator
- Have a uterine or tubal condition that prevents access to one or both tubal openings
- Might want to become pregnant
- Previously had a tubal ligation
- Recently gave birth or had an abortion
- Recently had a pelvic infection
After implantation of the Adiana system, an estimated 1 to 2 out of 100 women will get pregnant. If you do conceive after having the Adiana system implanted, there's a higher chance that the pregnancy will be ectopic — when the fertilized egg implants outside the uterus, usually in a fallopian tube. However, because pregnancy after sterilization is rare, the overall risk of ectopic pregnancy is lower than that of the general population.
The Adiana system doesn't offer protection from sexually transmitted infections.
Risks associated with the Adiana system include:
- Perforation of the uterus or fallopian tubes
- Tubal blockage occurring on only one side
How you prepare
Before you have the Adiana system implanted, your health care provider will likely:
- Ask about your reasons for choosing sterilization and discuss factors that could lead to regret, such as a young age
- Discuss the causes and probability of sterilization failure
- Discuss the need for you to use another method of contraception for three months following the procedure, or until tubal blockage is confirmed
- Explain the details of the procedure
- Reinforce that the Adiana system can't be reversed
- Review the risks and benefits of reversible and permanent methods of contraception
Your health care provider will also talk with you about choosing the right time to do the procedure. You may need to take a pregnancy test within 24 hours before you have the Adiana system inserted to confirm you're not pregnant. To further minimize the risk of inserting Adiana during pregnancy, your health care provider may schedule the procedure shortly after your period.
What you can expect
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The Adiana system is usually implanted as an outpatient procedure. Your health care provider may inject a local anesthetic into your cervix before the procedure, which typically lasts 15 minutes.
During the procedure
Your health care provider will insert a hysteroscope — a thin tube equipped with a camera lens — through your vagina and cervix into your uterus and then fill your uterus with fluid. This will allow your health care provider to see both fallopian tube openings.
Using a small catheter attached to the hysteroscope, your health care provider will use a bipolar electrical current to heat a portion of your fallopian tube, then he or she will place a tiny piece of silicone matrix inside your fallopian tube. Your health care provider will repeat the procedure on your other fallopian tube.
After the procedure
You may be allowed to go home immediately after the procedure and return to your normal activities the same day. Side effects may include:
- Bleeding or spotting
- Nausea or vomiting
- Pelvic or back pain
Contact your health care provider immediately if you have:
- Heavy bleeding
- Severe or persistent pelvic pain
During the three months following the procedure, you must use another method of contraception. After three months, you'll have an X-ray (hysterosalpingography) or an ultrasound to confirm the correct placement of the Adiana system and verify that your fallopian tubes are blocked. If the procedure is successful, you can stop using other forms of birth control at this point. If implantation isn't successful, you may need to repeat the procedure.
If you think you're pregnant at any time after the procedure, contact your health care provider immediately.
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- Smith RD. Contemporary hysteroscopic methods for female sterilization. International Journal of Gynecology and Obstetrics. 2010:108;79.
- Abbott J. Transcervical sterilization. Current Opinion in Obstetrics and Gynecology. 2007;19:325.
- Roncari D, et al. Female and male sterilization. In: Hatcher RA, et al. Contraceptive Technology. 20th ed. New York, N.Y.: Ardent Media, Inc.; 2011:435.
- Sterilization for women and men. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For20Patients/faq011.ashx. Accessed Dec. 15, 2011.
- Greenberg J. Hysteroscopic sterilization. http://www.uptodate.com/home/index.html. Accessed Dec. 12, 2011.
- Birth control methods. U.S. Department of Health and Human Services. http://www.womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.cfm. Accessed Dec. 12, 2011.