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Goldstuck N et al.  
Geometric Foundations of Intrauterine Device Complications and Implications for IUD Users – Importance of the IUD Size to maximize Tolerability and Prevent Early Discontinuation

Journal für Reproduktionsmedizin und Endokrinologie - Journal of Reproductive Medicine and Endocrinology 2015; 12 (4): 255-259

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Intrauterine devices (IUD) are long-acting reversible contraceptive methods that are independent from daily attention. Unlike methods that need daily motivation, IUDs are “forgettable” methods that are also highly effective. They are, therefore, advocated by all major organizations to prevent unintended pregnancy. However, current IUD use often leads to early discontinuation, even within 3 or 6 months following insertion. It is known for many years that IUDs perform best, leading to high continuation of use, if attention is given to geometric factors such as size and shape of the host uterine cavity prior to inserting an IUD. Continuation of use, for the full claimed duration of action, will usually remain low if the relationship between IUD and uterine cavity is out of proportion.
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