Immediate versus delayed IUD insertion after uterine aspiration.

Area of Science:

• Reproductive Health
• Contraception Research
• Gynecology

Background:

• Intrauterine devices (IUDs) are a highly effective, reversible long-term contraception method.
• IUDs are suitable for many women post-first-trimester uterine aspiration.
• Uncertainty exists regarding immediate vs. delayed IUD insertion effects on complications and usage rates.

Purpose of the Study:

• To compare the rates of IUD expulsion and usage between immediate and delayed insertion after uterine aspiration.
• To determine if immediate IUD insertion is non-inferior to delayed insertion regarding expulsion rates.
• To assess complication rates and overall IUD use at six months.

Main Methods:

• A randomized noninferiority trial was conducted.
• Participants included women undergoing uterine aspiration (5-12 weeks gestation) desiring an IUD.
• Women were randomized to immediate IUD insertion or delayed insertion (2-6 weeks post-procedure).

Main Results:

• Immediate IUD insertion was performed in 100% of cases, compared to 71.3% for delayed insertion.
• The 6-month IUD expulsion risk was 5.0% for immediate insertion versus 2.7% for delayed insertion (non-inferior).
• Six-month IUD use rates were significantly higher with immediate insertion (92.3%) than delayed insertion (76.6%).

Conclusions:

• Immediate IUD insertion post-uterine aspiration shows a higher, yet non-inferior, expulsion rate compared to delayed insertion.
• Immediate insertion leads to greater IUD utilization at six months.
• No significant increase in adverse events was observed with immediate IUD insertion.