Pelvic Ultrasound to Evaluate Parameters that may Affect Intrauterine Device (IUD) Placement Failure and Success

Intrauterine devices (IUDs) have become one of the most common types of contraception in the United States. In the last decade, the American College of Obstetricians and Gynecologists, the World Health Organization, and the Food and Drug Administration (FDA) updated IUD recommendations to include placement in younger populations and nulliparous women. Research has shown that younger, nulliparous women may have smaller uterine dimensions and it is possible that larger IUDs are not suitable for those populations. This study retrospectively evaluated follow-up pelvic ultrasounds showing uterine dimensions and IUD positions of 57 women who had IUDs placed in a clinic. The largest IUD, the Paragard, showed a significantly higher rate of malpositioning than the Kyleena, Liletta, and Mirena IUDs. There is concern that the Paragard IUD, which is most commonly malpositioned, is also the IUD most dependent on position for adequate contraception. There was no correlation between uterine dimensions and IUD position at the time of analysis, however. Further data collection will continue in hopes that a larger sample size will reveal a parameter which affects IUD placement. Should further data analysis show that uterine width plays an important role in IUD position, the design for a device which can measure the width of patient's uterus (without the need for pelvic ultrasound) has been included. The concept generation for this measurement device includes laser measurements of uterine cavity width at different known lengths from the fundal wall, which output to an LED screen for recording.