An Essure is a new office procedure that is used for permanent female sterilization. This is a procedure where the patient is brought into the office and a speculum is placed into vagina and then a small hysteroscope is placed in through the cervix and into the uterus. The uterus is then distended with fluid and the opening to the fallopian tubes are visualized. A small nickel-containing coil is placed in each fallopian tube to help block or occlude the fallopian tubes. After the procedure I ask my patients to use a backup form of contraception for 3 months. Then I have my patients have a hysterosalpingogram performed to see if the tubal scarring has occurred around these coils and to see if the fallopian tubes are blocked. This procedure carries an excellent sterilization rate and is a very good alternative to the traditional tubal ligation.