Last month, Consumer Reports weighed in on the controversy surrounding Essure risks, saying that women should understand the potential side effects of using this birth control device and ask their doctors several pointed questions.

Among them, the nonprofit suggested that women ask their doctors if they’re prepared to remove the device should problems arise.

Essure, which is manufactured by Bayer, is a permanent birth control solution that does not require surgery or anesthesia. It consists of two 1.5-inch metal coils that are inserted through the vagina into the fallopian tubes. Once in place, the coils induce scarring in the fallopian tubes that block eggs from descending from the ovaries into the uterus, which prevents fertilization.

Since its debut in 2002, more than 750,000 women worldwide have opted to use Essure despite mounting evidence of serious risks involved.

While the available data suggests that the overall complication rate for Essure is low, Consumer Reports found that those women who do experience a complication typically endure serious problems.

The article went on to say that “[r]oughly half of the almost 17,000 adverse-event reports involving Essure indicate that surgery—up to and including full hysterectomy—was needed to resolve the problem.”

When complications did arise, the women seeking help often found that the doctors who implanted the device did not know how to remove them. This naturally caused even more frustration for those women who wanted to have the device taken out.

As a result, Consumer Reports advised women to speak with their doctors not only about the risks involving Essure but also what to do if there is a complication.

“Ask whether your doctor has had to do any removals,” the article noted. “If he or she has, ask how many removal procedures and whether they were successful. An expert we spoke with estimates that it takes about 20 to become proficient.”

The FDA has previously directed that a black box warning must go on Essure packaging and the agency worked with Bayer to create a checklist that doctors can go over with their patients before implanting Essure in order to review key information about the device, its use, its effectiveness and its risks.

Earlier this year, it was announced that Essure would be removed from markets in Brazil, Finland, and the Netherlands. It is still available in the United States despite the advocacy of several women’s groups who are calling for it to be banned.

Among the advocates is famed environmental activist Erin Brockovich, who launched a website earlier this year encouraging women to share stories about Essure risks and real-life experiences.