IUDs are small, T-shaped birth control devices placed inside the uterus. They offer over 99% efficacy in preventing pregnancy when positioned correctly. However, an IUD can, in rare instances, shift from its intended position, known as displacement. This can compromise its ability to prevent pregnancy. Can you get pregnant with a displaced IUD?
Understanding IUD Displacement
IUD displacement refers to any situation where the device is no longer in its optimal position within the uterus. Partial displacement means the IUD has moved but remains inside the uterine cavity, often lower than its ideal placement. Complete expulsion occurs when the IUD falls out of the uterus entirely, sometimes unnoticed. Uterine perforation, the most serious form, is when the IUD penetrates or passes through the uterine wall. Displacement can be caused by strong uterine contractions, issues during insertion, uterine abnormalities, or a uterus that is smaller or larger than average.
Impact on Pregnancy Prevention
A displaced IUD significantly compromises its effectiveness in preventing pregnancy, as its primary mechanisms of action are hindered. Hormonal IUDs release progestin to thin the uterine lining, thicken cervical mucus, and suppress ovulation; a shifted IUD may not distribute this hormone evenly or sufficiently. Non-hormonal copper IUDs prevent pregnancy by causing a sterile inflammatory reaction in the uterus, creating an environment toxic to sperm and eggs and preventing implantation. If a copper IUD is displaced, this inflammatory response may not cover the entire uterine surface, allowing fertilization or implantation. Complete expulsion offers no contraceptive protection, and even partial displacement substantially reduces efficacy.
Recognizing Displacement and Taking Action
Recognizing IUD displacement signs is crucial. Indicators include a change in IUD string length (longer, shorter, or undetectable), new or worsening pelvic pain, cramping, or abnormal bleeding patterns like heavier periods or spotting. The IUD might also be felt during intercourse. If any of these signs occur, or if displacement is suspected, contact a healthcare provider immediately. Until the IUD’s position is confirmed, use a backup contraception method or abstain from intercourse; a healthcare provider can then perform a pelvic examination and use imaging, like an ultrasound, to confirm its location.
Considerations if Pregnancy Occurs
If pregnancy occurs with a displaced IUD, there are specific considerations and potential risks. Continuing a pregnancy with an IUD in place increases the risk of complications, including miscarriage (especially if the IUD is not removed), preterm labor, and uterine infection. Ectopic pregnancy, where the fertilized egg implants outside the uterus, is another serious concern. While IUDs prevent uterine pregnancies effectively, they are less effective against ectopic pregnancies, meaning a pregnancy with an IUD has a disproportionately higher chance of being ectopic. Healthcare providers will discuss options, often including IUD removal if safely accessible and if the individual wishes to continue the pregnancy; this decision is complex and made in consultation with a healthcare professional, weighing specific risks and benefits.