Long-term indwelling copper intrauterine device (IUD) found during primary infertility work up

Infertility is a public health concern worldwide. Hysterosalpingogram is a useful diagnostic tool to both evaluate the contours of the uterine cavity and to assess tubal patency. Intrauterine devices (IUDs) are the world's most prevalent form of long-acting reversible contraception. In this case, a 30-year-old P0 female, an immigrant from Jamaica, was referred for hysterosalpingogram for primary infertility workup. Under fluoroscopic imaging, an unexpected T-shaped IUD was visualized in the expected location of the uterus. The IUD lacked portions of the radiopaque copper lining. The patient initially denied IUD insertion. However, after further investigation, the patient's mother admitted IUD insertion at the age of 14 in Jamaica. This case raises a concern for the possibility of unexpected IUD discovery during infertility work up and emphasizes the importance of clinician awareness of the changes that may be seen on imaging when these devices are in place long-term.