A physician places the coils into the fallopian tubes by a catheter passed from the vagina through the cervix and uterus. This occurs successfully between 63% and 100% of the time. Once in place, the ingrowth continues over a period of three months, resulting in blockage in the Fallopian tubes; the tissue barrier formed is supposed to prevent sperm from reaching an egg. During that intervening three-month period, women are advised to use an alternate contraceptive method. Unlike tubal ligation, it may not require a general anaesthetic (though is often done under general anaesthetic). Despite this, some women have reported considerable pain during the procedure. In one 2007 prospective study, the mean time for procedure was 6.8 minutes (range = 5–18 minutes) for a trained physician to perform. The procedure can be performed in a physician's office. The procedure is reported to be permanent and not reversible by the manufacturer. Nevertheless, several<unk>  reversals have been performed. Device The small, flexible inserts are made from polyester fibers, nickel-titanium, stainless steel and solder. The insert contains inner polyethylene terephthalate fibers to induce inflammation, causing a benign fibrotic ingrowth, and is held in place by flexible stainless steel inner coil and a dynamic outer nickel titanium alloy coil. Unlike temporary methods of birth control, the<unk>  inserts do not contain or release hormones. The inserts do not prevent the transmission of sexually transmitted infections.
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