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Routine intrauterine device checks: are they advisable?

Isabel B Draper1, M Sayeed Haque, Richard J McManus

  • 1Whitehall Medical Practice, Rugby, UK. ibd@doctors.org.uk

The Journal of Family Planning and Reproductive Health Care
|August 4, 2011
PubMed
Summary
This summary is machine-generated.

Routine checks for intrauterine contraceptive devices (IUDs) may not be necessary. This study found no increased harm in women with infrequent IUD checks compared to frequent ones.

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Area of Science:

  • Reproductive Health
  • Contraception
  • Evidence-Based Medicine

Background:

  • Historically, routine checks for intrauterine contraceptive devices (IUDs) were standard practice.
  • Guidance shifted in 2004, with the National Institute for Health and Clinical Excellence deeming routine checks unnecessary.
  • This study aimed to evaluate the evidence supporting this updated guidance.

Purpose of the Study:

  • To examine the evidence regarding the necessity of routine checks for long-term intrauterine contraceptive device (IUD) users.
  • To compare adverse event rates between frequent and infrequent attenders for IUD checks.

Main Methods:

  • Retrospective analysis of case records for 272 patients at Whitehall Medical Practice using an IUD for at least 2 years.
  • Data extraction included demographics, IUD type, usage dates, check attendance, defaults, and side effects.
  • Kaplan-Meier survival analysis was used to compare outcomes based on check attendance frequency.

Main Results:

  • The study included 272 individuals and 423 IUD devices.
  • Frequent check attenders experienced adverse events at similar or earlier times compared to infrequent attenders.
  • No significant difference in adverse event timing was observed between frequent and infrequent check attendees.

Conclusions:

  • For patients using an intrauterine contraceptive device (IUD) for a minimum of 2 years, infrequent attendance for checks showed no evidence of harm compared to frequent attendance.
  • If generalizable, this suggests women could attend for IUD checks as needed after insertion.
  • Recall for smears and at the end of the IUD's lifespan may suffice, reducing the need for routine follow-ups.