Definition and Overview

IUD (intrauterine device) insertion is a contraceptive procedure that involves placing a T-shaped device inside the uterus to prevent fertilization. The main purpose is to prevent the sperm from reaching the egg, but in cases where fertilization takes place, the device works by preventing a fertilized egg from growing in the womb.

Unlike other surgical contraceptive procedures, IUD is both a long-term and reversible solution. Once it is installed, the patient will not have to worry about getting pregnant. However, once the patient decides to have children, the device can be easily removed from the uterus.

Who should undergo and expected results

IUD insertion can be performed on all adult females who do not want to become pregnant. This contraception method is a viable option as long as the patient is not suffering from a pelvic infection and not currently pregnant.

The expected results of the procedure are long-term and reversible contraception for the patient. The device can last for five to ten years, depending on the type of IUD used. Options include copper (nonhormonal) and hormonal IUDs. Copper IUDs have more than 99% effectiveness, and work by slowing down the movement of sperm, damaging the sperm cells, and increasing the amount of cervical mucus inside the womb.

On the other hand, hormonal IUDs release small amounts of progestin hormones that thicken the cervical mucus. This mucus prevents the sperm from penetrating the cervix.

It is important to note that while IUDs can prevent pregnancy, they cannot protect the patient from being infected by sexually transmitted diseases like other forms of contraceptive methods, such as condoms.

How the procedure works

Before IUD insertion, the doctor first examines the patient to determine the position and size of the womb. This is done to ensure that the IUD will be placed correctly and will function as expected. The doctor can also order several tests to rule out the possibility of pelvic infections and sexually transmitted diseases.

The procedure itself takes around fifteen to twenty minutes. The patient will be asked to change into a paper gown and lie down on an examination table. The device is then inserted into the uterus through the vaginal canal. The patient might feel pain or discomfort during the procedure, and can ask for pain relief.

After the IUD is inserted, the patient may experience abdominal cramps, which should go away within a couple of days. It is recommended that the patient returns to the clinic or hospital for an ultrasound within five to six weeks to ensure that the IUD is in place. Going for an ultrasound once every year is also highly recommended.

The patient herself can check the correct placement of the IUD by inserting a finger inside the vagina. The string should be right inside the canal. If the patient's partner can feel the string during intercourse, the patient can come back to the clinic to have the string shortened.

The doctor will advise the patient to refrain from putting anything inside the vagina (such as tampons) a full day after the procedure.

Possible risks and complications

There are some side effects that the patient can expect following the procedure. Copper IUDs are known for increasing the amount of menstrual bleeding, which will normalize within three months after the procedure. Hormonal IUDs, on the other hand, reduce the occurrence of painful menstrual cramps and bleeding.

Although very rare, the device can puncture the uterus. This often occurs during the insertion of the device. Expulsion of the IUD is relatively rare but occurs within the first year of having the device inserted.

Ectopic pregnancy, or pregnancy that occurs outside the uterus, can be a possible complication in women using copper or nonhormonal IUDs.

IUDs can also cause pelvic infections in some women. Pelvic inflammatory disease, associated with the insertion of intrauterine devices, can render the patient barren.

Some research shows a link between issues in the female reproductive system and the insertion of IUDs.

References:

  • Grimes DA (2007). Intrauterine devices (IUDs). In RA Hatcher et al., eds., Contraceptive Technology, 19th ed., pp. 117–143. New York: Ardent Media.

  • Dean G, Schwarz EB (2011). Intrauterine contraceptives (IUCs). In RA Hatcher et al., eds., Contraceptive Technology, revised 20th ed., pp. 147–191. New York: Ardent Media.

  • Speroff L, Darney PD (2011). Intrauterine contraception. In A Clinical Guide for Contraception, 5th ed., pp. 239–279. Philadelphia: Lippincott Williams and Wilkins.

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