The "forgotten" intrauterine device

Infertility caused by an unnoticed intrauterine contraception device: Case series

Infertility is one of the reproductive health issues that affects 10%-15% of couples. There are different factors causing infertility: male factors, female factors, and combinations of them. Knowing the causes of infertility is very important for treatment, and looking for them starts with a simple physical examination and progresses to invasive diagnostic procedures. Although it is rare, there are reports of unnoticed and forgotten intrauterine contraceptive devices causing infertility in different parts of the world. This is a case series of three women who had 3-5 years of infertility consultations and were discovered to have an unnoticed intrauterine contraceptive device. All of them had intrauterine contraceptive devices inserted years before they came to the clinic for an infertility work-up and were unaware of that. These intrauterine contraceptive devices were inserted at different health institutions without any counselling, consent, or information given to the women. The purpose of this case series is to remind health care providers that they should provide counselling, ensure that she understands the type, advantages, and disadvantages of contraception, and that her choices are based on voluntary, informed decision-making before providing any type of contraception to any woman.

Forgotten intrauterine device contributing to infertility

The aim of the study is to show that long standing forgotten intrauterine device contributes to infertility, reporting three cases presented at Central Hospital Warri, Nigeria, a government tertiary health center. Three cases of forgotten intrauterine contraceptive device (IUCD) contributing to infertility were seen. Two were inserted for contraceptive reasons while one was inserted while being managed for uterine synechae. Health care providers should ensure proper documentation of all procedures carried out, adequate counseling which should include taking an informed consent and also ensuring both short and long term follow up of their clients. Also all patients being evaluated for infertility and clients with past history of intrauterine device must have a speculum examination and ultrasound scan carried out.

'Forgotten' intrauterine device leading to actinomycotic pyometra--13 years after menopause

A case of a 'forgotten' intrauterine device (IUD) in a postmenopausal woman leading to Actinomyces israelii infection and pyometra is described. The patient was asymptomatic for 22 years after IUD insertion and developed the complications 13 years after menopause. To prevent such serious complications, it is important to ensure that intrauterine devices, once they have served the purpose and even if they are asymptomatic, are removed.

The pathology of intra-uterine contraceptive devices

The IUCD is a simple and effective way of producing contraception without the need for patient compliance. It is not rendered ineffective by other drugs, as may be steroid contraceptives, and its side-effects, for carefully selected patients, are considered by most practitioners to be acceptably low (Van Kets et al. 1989).

The "forgotten" intrauterine device: a cause of infertility

We present a case of infertility due to a "forgotten" IUD. Users of intrauterine devices are reported to have an increased risk of frank or subclinical genital infections which later may be the cause of infertility. Other mechanisms of causing infertility are possible. During the last two years we have seen three infertile patients with an IUD in situ. Two had ovulation, and one got pregnant immediately after the IUD was removed.