Experience of IUD/IUS insertions and clinical performance in nulliparous women - a pilot study

Objectives To assess experience of insertion and use, by nulliparous women, of intrauterine devices (IUDs) and intrauterine systems (IUSs) and the feasibility of a large comparative study. Methods Prospective pilot study of women attending for interval insertion of IUD/IUS or emergency IUD. Problems and experience of the procedure were noted. At three months and one year continuation rates, satisfaction levels and problems were recorded. Case notes were reviewed for non-responders. Results Between May and October 2005, 117 nulliparous women were recruited. Nine had an IUS inserted, and 104 an IUD. Despite a reasonable level of pain at insertion most women gave broadly positive descriptions of the procedure. At one year, 65 women were known to still have their original device. Fifteen had it removed; in six women it was expelled. The satisfaction score was high. There were no pregnancies or perforations. Conclusions Insertion of IUD/IUS was well tolerated by the majority. Continuation and satisfaction rates were high. The IUD/IUS should be offered to nulliparous women as part of the full contraceptive menu. The ease of recruitment in this pilot study suggests that a larger study is feasible.