Classic versus uterine sound-sparing approach for insertion of copper T380A intrauterine device: A randomized clinical trial

Abstract

Objective: The current study compares the efficacy of the classic approach and the uterine sounding sparing approach (a new approach) for copper intrauterine device (Cu-IUD) insertion. Study design: A randomized clinical trial. Setting: Woman's Health Hospital, Assiut, Egypt. Materials and methods: The current study was an open parallel randomized clinical study conducted in Assiut Woman’s Health Hospital, Egypt included women requesting Copper IUD insertion. Enrolled women were randomized into 2 groups; group I included women subjected to classic approach for Cu-IUD insertion and group II included women had Cu-IUD insertion using the uterine sound-sparing approach (USSA). This approach utilized transvaginal ultrasound (TV/US) for assessment of the uterine cavity length and position before IUD insertion without using uterine sounding. The primary outcome was the successful Cu-IUD insertion. Results: 46 women were analyzed in group I and 46 in group II. The pain during IUD insertion and 5 min post-insertion was significantly lower in group II than group I (p < .001). The Cu-IUD inserted easier in group I than group II (p < .001). Moreover; significant shorter duration of insertion was reported in group II (p = .002). More satisfied women were found in group II (p = .0001). At the 4 weeks follow-up; TV/US showed that all IUDs were in place in all women. Conclusions: Cu-IUD can be inserted successfully without using uterine sound provided using TV/US prior to insertion. This method associated with less pain, greater women satisfaction during insertion with shorter duration. Keywords: Intrauterine device, TV/US, Ultrasound, Contraception, Uterine sound