A 25-year-old woman attends the GP for her first LNG-IUS (Mirena) check at 6 weeks post-insertion. She reports that she cannot feel the threads hersel...

Question

A 25-year-old woman attends the GP for her first LNG-IUS (Mirena) check at 6 weeks post-insertion. She reports that she cannot feel the threads herself. On speculum examination, the threads are not visible at the cervical os. What is the single most appropriate next step?

Accepted Answer

Arrange a pelvic ultrasound to check whether the IUS is in situ - advise barrier contraception in the meantime

Answer

Assume the IUS has been expelled and prescribe alternative contraception only

Answer

Perform a blind retrieval attempt with thread retriever forceps in the GP surgery

Answer

No action needed - absent threads are always due to the threads curling up into the cervical canal

Answer

Arrange an X-ray to locate the IUS

uk-drcog MCQ (SBA): Missing IUS Threads - Ultrasound

A 25-year-old woman attends the GP for her first LNG-IUS (Mirena) check at 6 weeks post-insertion. She reports that she cannot feel the threads herself. On speculum examination, the threads are not visible at the cervical os. What is the single most appropriate next step?