Levonorgestrel-releasing (Mirena, Shering, AG Pharmaceutical, and newer versions)
Levonorgestrel-containing collar around stem
Works up to 5 years
Other IUDs
Plastic IUDs and Lippes loop IUD (older, 45 years back)
Round IUD of stainless steel ring in fundus with straight shaft in lower endometrium (commonly used in China)
Mechanism of action: Primarily prevents fertilization
Also has spermicidal effects and implantation inhibiting effects
Partially inhibit ovulation (Mirena only)
Copper devices increase copper levels → change in cervical mucus, affecting sperm motility and irritating endometrium
IMAGING
General Features
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Dean G et al: Intrauterine contraception (IUD): Overview: UpToDate. Updated July 14, 2014. Accessed August 15, 2014. http://www.uptodate.com/contents/intrauterine-contraception-iud-overview
Nowitzki KM et al: Ultrasonography of intrauterine devices. Ultrasonography. 34(3):183-94, 2015
Boortz HE et al: Migration of intrauterine devices: radiologic findings and implications for patient care. Radiographics. 32(2):335-52, 2012
Barber M et al: Uterine perforation and migration of an intrauterine contraceptive device in a 24-year-old patient seeking care for abdominal pain. J Chiropr Med. 10(2):126-9, 2011
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
Morales-Rosello J: Spontaneous upward movement of lowly placed T-shaped IUDs. Contraception. 72(6):430-1, 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
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Intrauterine contraceptive device (IUCD)
Definitions
IUD
Device inserted into endometrial cavity most commonly to prevent pregnancy
T-shaped polyethylene frame with polyethylene monofilament string
Levonorgestrel-releasing (Mirena, Shering, AG Pharmaceutical, and newer versions)
Levonorgestrel-containing collar around stem
Works up to 5 years
Other IUDs
Plastic IUDs and Lippes loop IUD (older, 45 years back)
Round IUD of stainless steel ring in fundus with straight shaft in lower endometrium (commonly used in China)
Mechanism of action: Primarily prevents fertilization
Also has spermicidal effects and implantation inhibiting effects
Partially inhibit ovulation (Mirena only)
Copper devices increase copper levels → change in cervical mucus, affecting sperm motility and irritating endometrium
IMAGING
General Features
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Dean G et al: Intrauterine contraception (IUD): Overview: UpToDate. Updated July 14, 2014. Accessed August 15, 2014. http://www.uptodate.com/contents/intrauterine-contraception-iud-overview
Nowitzki KM et al: Ultrasonography of intrauterine devices. Ultrasonography. 34(3):183-94, 2015
Boortz HE et al: Migration of intrauterine devices: radiologic findings and implications for patient care. Radiographics. 32(2):335-52, 2012
Barber M et al: Uterine perforation and migration of an intrauterine contraceptive device in a 24-year-old patient seeking care for abdominal pain. J Chiropr Med. 10(2):126-9, 2011
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
Morales-Rosello J: Spontaneous upward movement of lowly placed T-shaped IUDs. Contraception. 72(6):430-1, 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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