A trial included a total of 156 subjects undergoing medical abortion with mifepristone and misoprostol and choosing the copper IUD for contraception. Women were randomly assigned to "immediate" insertion 1 week after mifepristone or "delayed" insertion 4-6 weeks later. An IUD was inserted in 97% of participants in the immediate group and 76% in the delayed group. At 6 months, 69% of participants in the immediate group used the IUD compared with 60% in the delayed group. Expulsion rates were comparable; 12% (8/69) in the immediate group compared with 11% (7/65) in the delayed group. Removals occurred in 14% (10/69) of immediate and 8% (5/65) of delayed group participants. Four pregnancies occurred in delayed group participants who did not return for IUD insertion. The immediate and delayed groups reported a median of 20 and 19 bleeding or spotting days, respectively. No cases of serious infection, uterine perforation, or hemorrhage were detected.
In another trial , total of 129 women undergoing medical abortion with mifepristone and misoprostol up to 63 days gestation and opting for IUD were randomised to early insertion (day 5-9 after mifepristone) or delayed (routine) insertion (at 3-4 weeks after mifepristone). 116 women had a successful IUD insertion. There was no difference in expulsion rate between early (9.7%) vs. delayed (7.4%) insertion (risk difference -9.2 to13.4). Furthermore, 1.5% of women randomized to early and 11.5% to delayed insertion did not attend the follow up (proportion difference 10.0%, 95% CI 1.8 to 20.6%), and a higher proportion of women (41%) had had unprotected intercourse prior to returning for insertion in the delayed group compared with the early group (16%) (p = 0.015). Adverse events were rare and did not differ between the groups.
Date of latest search: 2013-02-09