When to Arrange Follow-up

Follow up after placement

It is recommended to have a follow up 4-12 weeks after placement to review satisfaction, manage side effects, ensure IUD has not been expelled, and ensure that the woman has not developed an infection. Back-up contraception may be advisable until this visit if placement was difficult or if the woman has previously experienced an expulsion.

• What to review:
  • Bleeding changes
  • Menstrual/Pelvic pain
  • Expulsion
  • Dyspareunia (including if partner feels string)
  • Role of string checks
  • Need for further STI screening
  • Here is a link to a Follow-up Sheet

• String check:
  • In an asymptomatic woman, a string self-check is sufficient, though some may prefer a speculum exam.
    • A bimanual examination may be useful in the presence of symptoms such as pelvic pain or discharge.
    • An ultrasound should only be performed when indicated:
      - Increased pain
      - Absent strings
      - Investigation of other pelvic pathology

SOGC Clinical Practice Guideline, Canadian Contraception Consensus (part 3): Chapter 7 – Intrauterine Contraception
Costescu D. and Guilbert E. et al. Preceptorship Program on IUC insertion - Module 3