Levonorgestrel releasing (Mirena, Shering, AG Pharmaceutical)
Levonorgestrel-containing collar around stem
Effective for up to 5 years
Other IUDs
Plastic IUDs and Lippes loop IUD (older)
Round IUD of stainless steel ring in fundus with straight shaft in lower endometrium (commonly used in China)
Mechanism of action: Primarily prevents fertilization
Induce endometrial and fallopian tube chronic inflammatory change
Spermicidal effects
Inhibits fertilization
Inhospitable environment for implantation
Partially inhibit ovulation (Mirena only)
Copper devices increase copper levels → change in cervical mucus, affecting sperm motility and irritating endometrium
Transcervical tubal occlusion device
Device/material inserted hysteroscopically into fallopian tubes for permanent sterilization
Essure (Conceptus, Inc.)
2 overlapping coils each with radiopaque end markers
Outer coil made of nitinol (nickel and titanium alloy)
Inner coil made of stainless steel wrapped in polyethylene terephthalate (PET) fibers
Outer coil expands upon release and conforms to tube wall
4 cm in length
1.5- to 2-mm expanded diameter
PET fibers elicit benign tissue ingrowth around and into device
Anchors device in place
Permanently obstructs fallopian tubes
Adiana (Hologic)
Hysteroscopic focal radiofrequency thermocoagulation of fallopian tube isthmus followed by intraluminal insertion of silicon elastomer matrix
IMAGING
General Features
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Benacerraf BR: Three-dimensional volume imaging in gynecology. Obstet Gynecol Clin North Am. 46(4):755-81, 2019
Rowlands S et al: Intrauterine devices and risk of uterine perforation: current perspectives. Open Access J Contracept. 7:19-32, 2016
Nowitzki KM et al: Ultrasonography of intrauterine devices. Ultrasonography. 34(3):183-94, 2015
Dean G et al: Intrauterine contraception (IUD): overview: UpToDate. http://www.uptodate.com/contents/intrauterine-contraception-iud-overview. Updated July 14, 2014. Accessed August 15, 2014
Boortz HE et al: Migration of intrauterine devices: radiologic findings and implications for patient care. Radiographics. 32(2):335-52, 2012
Guelfguat M et al: Imaging of mechanical tubal occlusion devices and potential complications. Radiographics. 32(6):1659-73, 2012
Simpson WL et al: Multimodality imaging of the Essure tubal occlusion device. Clin Radiol. 67(12):e112-7, 2012
Moschos E et al: Does the type of intrauterine device affect conspicuity on 2D and 3D ultrasound? AJR Am J Roentgenol. 196(6):1439-43, 2011
Benacerraf BR et al: Three-dimensional ultrasound detection of abnormally located intrauterine contraceptive devices which are a source of pelvic pain and abnormal bleeding. Ultrasound Obstet Gynecol. 34(1):110-5, 2009
Peri N et al: Imaging of intrauterine contraceptive devices. J Ultrasound Med. 26(10):1389-401, 2007
Muhler M et al: [How safe is magnetic resonance imaging in patients with contraceptive implants?] Radiologe. 46(7):574-8, 2006
Valsky DV et al: The shadow of the intrauterine device. J Ultrasound Med. 25(5):613-6, 2006
Letti Muller AL et al: Transvaginal ultrasonographic assessment of the expulsion rate of intrauterine devices inserted in the immediate postpartum period: a pilot study. Contraception. 72(3):192-5, 2005
Schiesser M et al: Lost intrauterine devices during pregnancy: maternal and fetal outcome after ultrasound-guided extraction. An analysis of 82 cases. Ultrasound Obstet Gynecol. 23(5):486-9, 2004
Caliskan E et al: Analysis of risk factors associated with uterine perforation by intrauterine devices. Eur J Contracept Reprod Health Care. 8(3):150-5, 2003
Hubacher D et al: Noncontraceptive health benefits of intrauterine devices: a systematic review. Obstet Gynecol Surv. 57(2):120-8, 2002
Stanford JB et al: Mechanisms of action of intrauterine devices: update and estimation of postfertilization effects. Am J Obstet Gynecol. 187(6):1699-708, 2002
Thonneau P et al: Risk factors for intrauterine device failure: a review. Contraception. 64(1):33-7, 2001
Tatum HJ et al: Management and outcome of pregnancies associated with the copper T intrauterine contraceptive device. Am J Obstet Gynecol. 126(7):869-79, 1976
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
TERMINOLOGY
Abbreviations
Intrauterine contraceptive device (IUCD)
Bilateral tubal ligation (BTL)
Levonorgestrel-releasing intrauterine system (LNG-IUS)
Definitions
IUD
Device inserted into endometrial cavity to prevent pregnancy
T-shaped polyethylene frame with polyethylene monofilament string
Levonorgestrel releasing (Mirena, Shering, AG Pharmaceutical)
Levonorgestrel-containing collar around stem
Effective for up to 5 years
Other IUDs
Plastic IUDs and Lippes loop IUD (older)
Round IUD of stainless steel ring in fundus with straight shaft in lower endometrium (commonly used in China)
Mechanism of action: Primarily prevents fertilization
Induce endometrial and fallopian tube chronic inflammatory change
Spermicidal effects
Inhibits fertilization
Inhospitable environment for implantation
Partially inhibit ovulation (Mirena only)
Copper devices increase copper levels → change in cervical mucus, affecting sperm motility and irritating endometrium
Transcervical tubal occlusion device
Device/material inserted hysteroscopically into fallopian tubes for permanent sterilization
Essure (Conceptus, Inc.)
2 overlapping coils each with radiopaque end markers
Outer coil made of nitinol (nickel and titanium alloy)
Inner coil made of stainless steel wrapped in polyethylene terephthalate (PET) fibers
Outer coil expands upon release and conforms to tube wall
4 cm in length
1.5- to 2-mm expanded diameter
PET fibers elicit benign tissue ingrowth around and into device
Anchors device in place
Permanently obstructs fallopian tubes
Adiana (Hologic)
Hysteroscopic focal radiofrequency thermocoagulation of fallopian tube isthmus followed by intraluminal insertion of silicon elastomer matrix
IMAGING
General Features
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Benacerraf BR: Three-dimensional volume imaging in gynecology. Obstet Gynecol Clin North Am. 46(4):755-81, 2019
Rowlands S et al: Intrauterine devices and risk of uterine perforation: current perspectives. Open Access J Contracept. 7:19-32, 2016
Nowitzki KM et al: Ultrasonography of intrauterine devices. Ultrasonography. 34(3):183-94, 2015
Dean G et al: Intrauterine contraception (IUD): overview: UpToDate. http://www.uptodate.com/contents/intrauterine-contraception-iud-overview. Updated July 14, 2014. Accessed August 15, 2014
Boortz HE et al: Migration of intrauterine devices: radiologic findings and implications for patient care. Radiographics. 32(2):335-52, 2012
Guelfguat M et al: Imaging of mechanical tubal occlusion devices and potential complications. Radiographics. 32(6):1659-73, 2012
Simpson WL et al: Multimodality imaging of the Essure tubal occlusion device. Clin Radiol. 67(12):e112-7, 2012
Moschos E et al: Does the type of intrauterine device affect conspicuity on 2D and 3D ultrasound? AJR Am J Roentgenol. 196(6):1439-43, 2011
Benacerraf BR et al: Three-dimensional ultrasound detection of abnormally located intrauterine contraceptive devices which are a source of pelvic pain and abnormal bleeding. Ultrasound Obstet Gynecol. 34(1):110-5, 2009
Peri N et al: Imaging of intrauterine contraceptive devices. J Ultrasound Med. 26(10):1389-401, 2007
Muhler M et al: [How safe is magnetic resonance imaging in patients with contraceptive implants?] Radiologe. 46(7):574-8, 2006
Valsky DV et al: The shadow of the intrauterine device. J Ultrasound Med. 25(5):613-6, 2006
Letti Muller AL et al: Transvaginal ultrasonographic assessment of the expulsion rate of intrauterine devices inserted in the immediate postpartum period: a pilot study. Contraception. 72(3):192-5, 2005
Schiesser M et al: Lost intrauterine devices during pregnancy: maternal and fetal outcome after ultrasound-guided extraction. An analysis of 82 cases. Ultrasound Obstet Gynecol. 23(5):486-9, 2004
Caliskan E et al: Analysis of risk factors associated with uterine perforation by intrauterine devices. Eur J Contracept Reprod Health Care. 8(3):150-5, 2003
Hubacher D et al: Noncontraceptive health benefits of intrauterine devices: a systematic review. Obstet Gynecol Surv. 57(2):120-8, 2002
Stanford JB et al: Mechanisms of action of intrauterine devices: update and estimation of postfertilization effects. Am J Obstet Gynecol. 187(6):1699-708, 2002
Thonneau P et al: Risk factors for intrauterine device failure: a review. Contraception. 64(1):33-7, 2001
Tatum HJ et al: Management and outcome of pregnancies associated with the copper T intrauterine contraceptive device. Am J Obstet Gynecol. 126(7):869-79, 1976
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