Levonorgestrel Intrauterine Device Placement in Uterine Anomalies: A Case Series

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 that IUDs are category 4 for people with uterine cavity distortions; however, there are previous case reports of their successful use in this population.

We present 5 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.

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