What to Review at Follow-up

Follow-up Checklist

• Overall satisfaction
• Bleeding pattern (flow, spotting, and cramping)
• Pelvic pain
• Progestin side effects
• Dyspareunia
• Any concerns with intercourse for a woman or her partner
• String check
• Need for further follow-up
• When to replace the device

Follow-up after a difficult placement

If placement was difficult, follow-up should take place sooner, around 4 weeks.

• Verify positioning with ultrasound (preferred) or X-ray. All IUC are radio-opaque.
• Remove device if not properly positioned in the intrauterine cavity and insert a new one. Do not reinsert a device that has been removed.
• If there is clinical suspicion of perforation at the time of placement, an urgent assessment with ultrasound is preferred. In most cases following a difficult placement, the IUC will be in the correct location.

SOGC Clinical Practice Guideline, Canadian Contraception Consensus (part 3): Chapter 7 – Intrauterine Contraception
Black D. and Waddington A. et al. Build Your Expertise: IUC slide deck: 96.
Costescu D. and Guilbert E. et al. Preceptorship Program on IUC insertion - Module 4