Pilot Bi-Lateral Tubal Occlusion Trial for Female Permanent Contraception

Prospective, multi-center, pilot study of subjects undergoing the FemBloc Permanent
Contraceptive System procedure to be conducted at up to 5 sites in the U.S. enrolling up to
50 subjects total. The objective of the trial is to evaluate the safety of the FemBloc
Permanent Contraceptive System for female sterilization in preventing pregnancy through the
3-month confirmation test visit. Following the pilot safety endpoint analysis at 3-month
follow-up, Femasys intends to continue follow-up of pilot subjects for a total duration of
approximately 68 months after the FemBloc treatment procedure.

Inclusion Criteria:

- Female, 21 - 45 years of age desiring permanent birth control

- Agreement to use temporary birth control (excluding IUC) until documented occlusion

- Sexually active (minimum of 4 coital acts per month) with male partner who is not
known or suspected to be sterile

- At low risk for sexually transmitted infection and / or monogamous

- Reasonably certain subject is not pregnant at time of screening and procedure visits

- Willing to accept the risk of pregnancy while relying solely on FemBloc for
contraception

- Signs informed consent agreeing to the protocol requirements and is able to meet the
trial schedule

Exclusion Criteria:

- Uncertainty about the desire to end fertility

- Suspected or confirmed pregnancy

- Prior tubal surgery

- Uterine anomaly such as unicornuate, bicornuate, arcuate, septate, and didelphic

- Known endometrial or myometrial conditions (e.g. submucous leiomyoma) or uterine
position (e.g. retroflexion or anteflexion) that would interfere with insertion tube
midline fundal placement, access to uterine cornua, or lateral deployment of the
catheters

- Any condition which may prohibit proper visualization of the cervix or not allow the
uterus to be appropriately instrumented

- Active or untreated pelvic infection

- Presence or suspicion of gynecologic malignancy

- Any condition or medical treatment (e.g. systemic corticosteroids or chemotherapy)
that compromises immune system

- Post-partum or pregnancy termination <6 weeks of scheduled procedure

- Complicated IUC removal on the day of FemBloc treatment (e.g. use of intracavitary
instrument for removal, bleeding, excessive pain)

- Scheduled to undergo concomitant intrauterine procedures at the time of FemBloc
treatment or planning any uterine procedure within the 3 months after treatment

- Known hypersensitivity to cyanoacrylate or formaldehyde

- Prior history of ectopic pregnancy

- Abnormal uterine bleeding of unknown etiology

- Any general health condition or systemic disease that may represent, in the
Investigator's opinion, a potential increased risk associated with device use or
pregnancy, or that would not allow them to complete the trial