As I always do, I will start by saying that most women do very well with these devices. If you have a reason to remove them it is important to remove them completely.
The Essures are tiny springs about an inch and ¼ long and no wider than the lead in a mechanical pencil. They are inserted into a woman’s uterus and passed into the point where the fallopian tube enters the uterine cavity. When properly inserted, part is in the uterine cavity, part is in the uterine wall and part is in the fallopian tube. Removing the part in the tube is done by cutting that part out. To get the other two parts out can be best done by removing the inner part of the Essure first and then the outer part. We feel that the best way to remove the rest is microsurgically because it takes the ability to feel how hard you are pulling. If you pull too hard and break the device you have to have the ability get the fragments out. With laparoscopy or robotic surgery this is not physically possible.
The Essures springs are made of an alloy of two metals nickel and titanium and the nickel is responsible for most of the problems that some women have with these devices. The heavy bleeding that some women have is probably related to the part that is in the uterus because they act like an intrauterine contraceptive device (IUD) which can cause heavy bleeding. If the surgeon removing the Essure leaves the part in the uterine cavity behind the bleeding may not stop. I am aware of a report of an IVF pregnancy being successful without removing the Essures but I feel it is clearly a good idea to remove the Essures first before trying IVF.