Intrauterine contraceptive device

Intrauterine contraceptive devices (IUCD) (also known colloquially as the coil) are one of the most frequently used methods of contraception throughout the world. It prevents pregnancy by:

  • thinning the endometrial lining
  • preventing sperm motility
  • preventing implantation

There are two main types of intrauterine contraceptive devices:

  • non-hormonal metallic
    • copper: pure copper or alloyed with gold/silver
    • stainless steel: a.k.a. Chinese ring, manufacture ceased in 2000
  • hormonal (e.g. Mirena®)

The preferred abbreviation for an intrauterine contraceptive device is IUCD. Occasionally IUD is employed instead, however, this shortening is disliked by specialists as it is also used as an abbreviation for intrauterine death.

  • all IUCDs are radiopaque 6
  • most often 'T-shaped' or at times seen as a serpiginous structure
  • preferred modality for assessing an IUCD
  • properly-placed IUCD may be visualized as a straight hyperechoic structure in the endometrial canal of the uterus and the arms of the IUD extending laterally at the uterine fundus
  • often causes posterior acoustic shadowing
  • distance >4 mm is more often associated with symptoms such as bleeding and pain, as well as with a higher risk of expulsion or displacement ref although most low IUCDs migrate to the fundus in a few months 6
  • in cases where it becomes embedded, a part of it may be visualized within the myometrium

3D ultrasound may be useful to help visualize the IUCD location (especially with serpiginous IUCDs) 2.

  • hyperattenuating structures with metallic density

The MRI compatibility of IUCDs may be of concern to women undergoing MRI examinations. Generally speaking, stainless steel devices are unsafe and non-metallic devices are considered safe. Copper devices have been found to be conditionally safe at 1.5 and 3.0 T 11.

The forerunner to the intrauterine contraceptive device was first introduced by the German physician, Richard Richter of Waldenburg, in 1909 4,5. His device comprised a loop of silkworm gut placed into the endometrial cavity 5.

Ultrasound - gynaecology
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Article information

rID: 4938
Synonyms or Alternate Spellings:
  • Chinese ring
  • Coil (contraception)
  • IUDs
  • IUCDs
  • Intra uterine device (IUD)
  • Intrauterine device (IUD)
  • Intrauterine device
  • IUCD
  • Intra uterine contraceptive device
  • Intrauterine contraceptive device (IUCD)
  • Intra-uterine contraceptive device (IUCD)
  • IUD

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Cases and figures

  •  Case 1
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  • Case 2: the 'Chinese ring' intrauterine contraceptive device
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  • Case 3: with migration
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  • Case 4: with migration
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  • Case 5: peritoneal migration
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