Performance of copper intrauterine devices when inserted after an expulsion

Abstract

A total of 124 women who re-inserted a TCu-200B intrauterine device (IUD) following an expulsion were followed up for 1 year after the IUD re-insertion. The cumulative expulsion rate at 6 months was 21.7 and 31.4 per 100 women at the end of the first year. Women who expelled the first IUD within the first 3 months of use had a significantly higher expulsion rate with the second IUD. Our conclusion is that women who expelled a copper IUD are at a significantly higher risk of expelling the re-inserted IUD than the first IUD. Health workers must also be informed about the high probability of another expulsion when re-inserting an IUD after an expulsion.

Partial and complete expulsion of the Multiload 375 IUD and the levonorgestrel-releasing IUD after correct insertion

“…About 40% of these women experienced a partial or complete re-expulsion, which is similar to the 41% re-expulsion for the copper T 200B IUD reported by Bahamondes et al [5]. This is the first study demonstrating that previous expulsion has to be considered a risk factor for re-expulsion in LNG-IUD users, too.…”

“…The risk of pregnancies in IUD users can be increased by incorrect insertions and partial or complete expulsions. Several studies show that the rate of complete expulsions varies from 2 to 8 per 100 women in the first year after insertion [3][4][5]. Partial expulsions may cause symptoms including menorrhagia or pain.…”

Length of the endometrial cavity and intrauterine contraceptive device expulsion

“…A higher expulsion rate was reported among women who had a second T-shaped IUD inserted immediately following expulsion of the first one-the expulsion rate 1 year after re-insertion of the device was 31.4% [9]. Similar findings were reported after re-insertion of copper or LNG-IUS devices [10].…”

“…However, this difference is minimal (0.28 cm) [13] and probably clinically insignificant. The likelihood of TCu380A expulsion decreases as a function of the skill of the professional inserting the device, with lack of professional skill being the main factor involved in the early expulsion of copper-containing IUD [8,9,25]. The same holds true for the LNG-IUS [26].…”

Levonorgestrel containing intrauterine device (Mirena®) in the treatment of dyfunctional uterine bleeding; patients’ view and our experience

“…According to several studies, expulsion rate of coppercontaining IUDs is between 2, and 8% during the first year after insertion [7][8][9] . In the literature, expulsion rate of Mirena® is found to be 7.5% 10 , 8.5% 11 and 16% 12 , and 37.5% 13 .…”