Study of intrauterine device insertions and clinical performance in nulliparous women

A. Brockmeyer and M. Kishen

Abacus Clinics, Liverpool, United Kingdom

Background There is increased interest in intrauterine devices (IUD) from nulliparous women. The reasons include concerns about potential side-effects or perceived long term risks of hormonal contraception. Several studies have proven the efficacy and safety of standard IUDs. However, there are no studies about acceptability, removal rates for pain and bleeding and the rate of spontaneous expulsions of the standard IUDs and the IUS routinely used in the UK in nulliparous women.

Objectives to assess experience of IUD/IUS fitting and use by nulliparous women.

Methodology This pilot is a prospective study conducted at the main sexual health clinic, Central Abacus, in Liverpool, UK. Nulliparous women having IUD/IUS insertions were recruited. A sexual history was taken and testing for sexually transmitted diseases (STI) carried out if appropriate. A questionnaire was filled out at the time of IUD/IUS insertion, indicating any problems and documenting the client's experience of the procedure. The women agreed to be contacted by postal questionnaire or by phone three months and one year after insertion.

Results A total of 118 women were recruited between May and October 2005. Of these 112 had an IUD/IUS fitted. 35 women (31.2%) had a T Safe Cu 380A, 53 women (47.3%) a Nova T, 14 women (12.5%) a GyneFix device, 9 women (8.0%) a Mirena and 1 woman (0.9%) a Multiload device. There were 2 failed insertions (1.8%). 27 women (24%) had local anaesthesia. In 41% of IUD fittings the clinicians found the fitting procedure easier than expected. The majority of women experienced the fitting procedure to be less painful than expected. The results of the three month follow-up will be presented at the conference.

Conclusion IUD/IUS fittings are well tolerated by nulliparous women. The supports the National Institute for Clinical Excellence (NICE) guidelines of 2005 that state that all women should be given a full choice of methods including the long acting methods like the IUD/IUS.