••• Chapter 61^ Family Planning and Sterilization^619
❍ What is the rate of IUD expulsion?
2% to 10% in the first year.
❍ When should the IUD be inserted in the postpartum period?
Within the first 10 minutes after the placenta delivers, or at 6 to 8 weeks. If the IUD is inserted 1 to 2 days after
delivery, the risk of expulsion increases. Women who are immediately postabortal or spontaneous abortion may
also have an IUD placed.
❍ For postcoital contraception, when should the IUD be inserted?
The copper IUD may be used within 120 hours of unprotected intercourse.
❍ What is the incidence of uterine perforation with IUD insertion?
1/1000. The string may still be visible in the os.
❍ What are the noncontraceptive benefits of the IUD?
The IUD reduces the risk of endometrial and cervical cancer. The levonorgestrel IUD reduces the risk of PID,
reduces dysmenorrhea and menstrual bleeding, can treat endometrial hyperplasia and cancer, and may decrease
endometriosis pain. The levonorgestrel IUD can also be used to protect the endometrium in women on estrogen
replacement.
REFERENCE
Barone MA, Nazerali H, Cortez M, et al. A prospective study of time and number of ejaculations to azoospermia after vasectomy by
ligation and exicision. J Urology 2003;170(3):892-96.