Clinical Inquiries

What are the benefits and risks of IUDs in adolescents?

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References

A retrospective cohort study that compared 36 nulliparous women with 83 parous women 18 to 41 years of age who were trying to conceive after removal of the GyneFix (copper) IUD found no statistical difference in pregnancy rates for age or duration of IUD use. Among women younger than 30 years, nulliparous women conceived earlier than parous women; cumulative pregnancy rates after 12 months were 100% for nulliparous and 80% for parous women (P=.007). No ectopic pregnancies were observed.6

Recommendations

The United Kingdom’s National Institute for Health and Clinical Excellence states that IUD use isn’t contraindicated in nulliparous women of any age, and that women of all ages may use IUDs. The Institute also states that no specific restrictions limit the use of copper or levonorgestrel IUDs by adolescents.

All women at risk for sexually transmitted infections may need to be tested before insertion. No evidence exists for a delay in return to fertility after removal or expulsion of an IUD.7

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Evidence-based answers from the Family Physicians Inquiries Network

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