LEVONORGESTREL INTRAUTERINE DEVICE PLACEMENT IN UTERINE ANOMALIES: A CASE SERIES

Background: Levonorgestrel intrauterine devices (IUDs) provide effective contraception and medical benefits. They are safe for even severely medically complex patients. The CDC Medical Eligibility Criteria (MEC) states IUDs are category 4 for people with uterine cavity distortions, however there are previous case reports of their successful use in this population.

Cases: We present five cases of IUD use in uterine anomalies utilizing ultrasound or hysteroscopy for intra-cavitary placement confirmation. With up to 4.5 years of follow up, our expulsion rate is 40%. In those whose IUDs were expelled, the expulsion happened within 4 weeks of placement.

Conclusion: IUD use in uterine anomalies is possible and generally safe but expulsion is high. Early IUD expulsion within 4 weeks of placement could indicate undiagnosed uterine anomaly.