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Intrauterine contraceptive device: Insertion and removal

Authors
Daniela A Carusi, MD, MSc
Alisa B Goldberg, MD, MPH
Section Editor
Robert L Barbieri, MD
Deputy Editor
Kristen Eckler, MD, FACOG

INTRODUCTION

Insertion of intrauterine contraception is an office procedure requiring specific patient preparation and technical skills. Training may be obtained in the clinical setting or may be provided by the manufacturers of these devices. This review is not intended as a substitute for training.

Several terms are used to describe intrauterine contraception, including intrauterine device (IUD) and intrauterine contraceptive (IUC); the progestin-containing device is also referred to as an intrauterine system (IUS). In this topic, we use the term IUC for all types of intrauterine contraception.

This topic will address technical issues regarding the insertion procedure for the IUCs available in the United States: a copper IUD (TCu380A, Paragard) and two doses of levonorgestrel-releasing IUDs (LNg20 andLNg14). Other aspects of intrauterine contraception are reviewed separately. (See "Intrauterine contraception: Devices, candidates, and selection" and "Intrauterine contraception: Management of side effects and complications".)

PREPROCEDURE

Candidates for and selection of an IUD — Appropriate candidates for intrauterine contraception, types of intrauterine devices (IUDs), and the advantages and disadvantages of the various devices are discussed in detail separately. Nulliparous women, adolescents, women who are postpartum or postabortion, and women desiring emergency contraception or sterilization should be included among those considered to be appropriate candidates for intrauterine contraception [1]. (See "Intrauterine contraception: Devices, candidates, and selection".)

Contraindications — The provider should ensure that the patient has no absolute contraindications to IUD use (table 1). If relative contraindications are present (table 2), these should be discussed and then the provider and patient can decide together whether the overall benefits of IUD use outweigh potential patient-specific risks.

                                

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Literature review current through: Nov 2016. | This topic last updated: Thu Feb 04 00:00:00 GMT 2016.
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