Preparing for a complex IUD (coil) removal appointment

The aim of this webpage is to help you to prepare for removal of your ‘lost’ or complex copper or hormone IUD (coil). To make your clinic visit as straightforward as possible and to ensure that the procedure takes place, it is important that you have read all the information provided. Reproduced with permission from Leeds Sexual Health.

Before your appointment

It is important there is no risk of pregnancy on the day you attend. If there is a risk of pregnancy we will be unable to go ahead with the procedure.

If you are worried regarding pregnancy risk at any time please contact your GP or a sexual health clinic so they can offer you emergency contraception.

• If your IUD is still in date and can be used for contraception: Ensure no unprotected sex for the 7 days before your appointment. Either use condoms, or do not have sex.
• If your IUD has expired for contraception or you have been told not to rely on it for contraception (for example, scan shows it is low in your womb: Ensure no unprotected sex for 3 weeks (21 days) before your appointment. Either use condoms or do not have sex.
• If you are unsure if you can rely on your IUD for contraception, please ring your us or your GP to seek further advice.

On the day of your appointment

• We recommend that you take a painkiller (such as paracetamol or ibuprofen) up to one hour before your appointment
• Please eat and drink something before your appointment
• Please do not bring children with you. Children will not be able to come into the room with you when you have the procedure and there are no childcare facilities
• It is OK to have an IUD procedure if you are bleeding; please attend your appointment as planned.

During your appointment

You will be seen by a doctor who will have a chaperone in the room to help with the equipment and look after you. The appointment generally lasts around 40 minutes.

The doctor will explain the procedure and risks and answer any of your questions.

You will lie on the bed undressed from the waist down. We might need to do an internal ultrasound scan during the appointment and will offer you screening for sexually transmitted infections.

A speculum (plastic tube device) will be inserted into the vagina to allow us to look at the neck of the womb. We use local anaesthetic spray to reduce the pain. We will then start to explore the neck of the womb and the womb for the IUD threads. This is a very common procedure and the clinicians you see are experienced in removing IUDs with lost threads. If you would like a new IUD we can fit this at the same appointment.

Rarely, the procedure can’t be completed in the outpatient clinic and you will be referred on to the hospital to have a hysteroscopy (camera into the womb to look for the IUD).

After the procedure

Most people are well enough to carry on with their usual activities but if you have a demanding job it might be a good idea to take the rest of the day off.

After the procedure you may not feel ready to drive home or take public transport. It is good to have a backup plan and someone to call to take you home if necessary, especially if you have travelled a long way.

It is normal to have some mild crampy abdominal pain and bleeding for the next few days.