For most gynecologists, IUD insertion and removal are common aspects of caring for patients of reproductive age. To strengthen your knowledge of this process and help hone your skills, read our collection of frequently asked questions about IUD insertion, location and removal.
- How does ultrasound help with IUD placement? An IUD is a highly effective form of contraception that can prevent pregnancy for 3 to 10 years, depending on the type of device. IUD placement can be achieved during a short exam using a vaginal speculum and a dedicated tool to slide the IUD through the opening of the cervix. A quick post-insertion ultrasound scan is the most efficient way to make sure the device is positioned correctly.
- How can I prevent complications during IUD insertion? Even experienced clinicians may encounter complications, including uterine perforation, during IUD insertion. You can reduce your chances of such risks by using 3D ultrasound, both to accurately locate the uterus before insertion and to confirm that the IUD is positioned properly within the uterine cavity after insertion.
- What does an IUD ultrasound image look like? Copper IUDs and hormonal IUDs each appear differently on an ultrasound. For instance, ring-down artifacts are common with copper IUDS. Although 2D ultrasound was previously the imaging method of choice for evaluating the uterus and determining IUD placement, 3D transvaginal ultrasound provides greater clarity, especially when viewing the small poylethylene frame of a hormonal IUD.
- Is there a steep learning curve for using ultrasound for IUD location? Training is key for physicians who plan to make the transition from X-rays and CT scans to ultrasound for locating IUDs. The change from 2D to 3D ultrasound should be fairly seamless. This upgrade is critical for overcoming situations that are difficult to image accurately using 2D ultrasound, such as an IUD with twisted arms.
- What are the signs of an IUD embedded in the uterus? Pain and bleeding can indicate that an IUD has become embedded in the uterus. An incorrectly positioned device can also perforate the serosa or cause fragmentation of the IUD, as well as increase the chances of unwanted conception. Research suggests that 3D ultrasound is more effective than 2D ultrasound in identifying malpositioned IUDs.
- IUDs and menopause: What's the benefit? For patients who are nearing menopause but still menstruating, IUDs are a good choice for contraception. IUDs lack many of the potential risks associated with oral contraceptives and other hormonal forms of birth control. Depending on the type of implant and the health of the patient, women in their 40s may be able to keep the same IUD until menopause.
- How effective is ultrasound in IUD removal? When a patient is ready to have their IUD removed, ultrasound guidance can play an integral role in the process. In cases where IUD strings are not visible, clinicians should consider using ultrasound to confirm an intrauterine IUD. For these patients, ultrasound guidance can help improve outcomes. It is also much more cost effective and often more comfortable than IUD removal in an operating room.
When approaching IUD insertion, location and removal, 3D ultrasound can offer clinicians valuable imaging guidance — every step of the way.
