Insertion of an Intrauterine Contraceptive Device (IUCD)

The insertion of an IUCD is a medical procedure that involves placing a small, T-shaped device into the uterus to provide long-term contraception. The procedure is typically performed by a healthcare provider in a clinical setting.

Pre-Insertion Preparation

• A thorough medical history and physical examination are conducted to ensure the patient is a suitable candidate for IUCD insertion.
• A pregnancy test may be performed to confirm the patient is not pregnant.
• The patient's cervix is cleaned with an antiseptic solution to reduce the risk of infection.
• A local anesthetic or pain relief medication may be administered to minimize discomfort during the procedure.

Insertion Procedure

1. The healthcare provider will insert a speculum into the vagina to visualize the cervix.
2. The cervix is then grasped with a tenaculum, an instrument used to stabilize the cervix and provide traction.
3. The IUCD is loaded into an inserter tube, which is then inserted through the cervical canal and into the uterus.
4. Once the IUCD is in place, the inserter tube is withdrawn, leaving the device in the uterus.
5. The healthcare provider will then trim the strings of the IUCD to the appropriate length and ensure the device is properly positioned.

Types of IUCDs

• Copper IUCDs: These devices release copper ions, which act as a spermicide, preventing fertilization. Examples include the ParaGard and Nova-T.
• Hormonal IUCDs: These devices release progestin, a hormone that thickens cervical mucus, preventing sperm from reaching the egg. Examples include the Mirena, Skyla, and Kyleena.

Post-Insertion Care

• The patient may experience some cramping, bleeding, or dizziness after the procedure, which can be managed with pain relief medication.
• A follow-up appointment is typically scheduled 4-6 weeks after insertion to ensure the IUCD is properly positioned and the patient is not experiencing any complications.
• The patient should check the strings of the IUCD regularly to ensure it is still in place.

Risks and Complications

• Perforation: The IUCD can puncture the uterus or cervix, requiring surgical removal.
• Infection: Bacterial infections, such as pelvic inflammatory disease (PID), can occur after insertion.
• Expulsion: The IUCD can be expelled from the uterus, often during menstruation.
• Pregnancy: Although rare, pregnancy can still occur with an IUCD in place.

Contraindications

• Pregnancy or suspected pregnancy
• Active pelvic infection
• Undiagnosed abnormal uterine bleeding
• Cancer of the uterus or cervix
• Allergy to copper or progestin (depending on the type of IUCD)

Benefits

• High efficacy: IUCDs are over 99% effective in preventing pregnancy.
• Long-term contraception: IUCDs can provide contraception for 5-10 years, depending on the type.
• Reversible: IUCDs can be removed at any time, allowing for rapid return to fertility.
• Low maintenance: Once inserted, IUCDs require minimal maintenance and do not interfere with daily activities.