Routine intrauterine device checks: are they advisable?

BACKGROUND Patients using the intrauterine contraceptive device (IUD) were previously advised to undergo routine checks; in 2004, the National Institute for Health and Clinical Excellence stated the practice was unnecessary. This study was conducted to examine the evidence for this advice. METHODS A retrospective examination of case records of patients of Whitehall Medical Practice, Rugby, UK who had used an IUD for a minimum of 2 years was performed. Data were extracted concerning demographic details, types of IUD used, dates of their use and of any checks, defaults from checks and side effects. Kaplan-Meier survival analysis was performed to compare outcomes in frequent and infrequent attenders, and in frequent and infrequent defaulters from checks. RESULTS The study population comprised 272 individuals using a total of 423 devices. Frequent check attenders showed adverse events earlier, or at no significant time difference, to infrequent attenders. CONCLUSIONS Considering patients who use an IUD for a minimum of 2 years, this study found no evidence of harm occurring in those who attended infrequently compared to frequent attenders. If these data from a single practice are generalisable, after an initial check following insertion, women can be asked to attend as needed and only be recalled for smears and at the end of the life of the IUD.