Fitter resources
Step-by-step instructions to guide you through the preparation and fitting of IUS/IUD.
The summary of product characteristics should be referred to before fitting an IUS or IUD.
Practical aspects of fitting an IUS[5]
Only to be inserted by a trained healthcare professional using aseptic technique.
First, open the sterile package completely. Then use sterile technique and sterile gloves.
Do not pull the slider downwards as this may prematurely release the LNG-IUS.
Once released, the LNG-IUS cannot be re-loaded.
REMOVAL:
- Mirena® (levonorgestrel 52mg) should be replaced after 4-8 years (depending on indication)
- Kyleena® (levonorgestrel 19.5mg) should be replaced after 5 years
- Jaydess®▼ (levonorgestrel 13.5mg) should be replaced after 3 years.
Mirena® (52mg levonorgestrel) Prescribing Information
Practical aspects of fitting an IUD[6]
The IUD may be used by trained medical staff only. We recommend using sterile gloves to minimise the risk of contamination.
a) Insertion tube e) Nylon threads
b) Insertion body f) IUD stem
c) Plunger g) Side arms
d) Blue flange h) Blue marking
- Open the sterile packaging of the T-Safe® CU 380A QL.
- While holding the nylon threads (e) straight, place the plunger (c) into the insertion body (b) up to the lower end of the IUD stem (f). By carefully pushing the plunger up to the blue marking on the insertion tube (a), both side arms (g) of the IUD slip into the tube. The upper end of the now ready-loaded IUD must jut only 2 mm out of the insertion tube.
NOTE: Due to the soft and flexible insertion tube, the side arms may twist while being pushed upwards. Please adjust the sliding blue flange as described in step 3, above. The side arms of the T-Safe® Cu 380A QL must not remain bent for over five minutes within the insertion tube, or they may not bend back completely and may not return to their original 90° angle.
REMOVAL: T-Safe® Cu 380A QL should be replaced after ten years.
Post-insertion advice
Provide patients with a patient information leaflet and advice post-insertion of IUS/IUD is an important component of patient care.
Key advice to be offered includes:[3]
- Expect cramping that usually lasts for 24-48 hoursBut may last longer and resolves thereafter and usually does not persist.
- Informing the patientOn how to feel the threads (e.g. before the next episode of sexual intercourse and after her next menses) and advise her to seek medical advice if she is unable to feel them.
Discuss the following points with patients:
- Bleeding
- Infection
- If the patient is feeling well enough to leave and is comfortable
- A follow-up appointment with the patient for 6 weeks’ time
Good practice points for documentation[8]
Detailed documentation is a key component of good practice in IUS/IUD fitting. Important points to document include:
Adapted from FSRH 2019
Step-by-step video guidance for the preparation, insertion, removal and replacement of the Bayer IUS
Intrauterine techniques training programme: LoC IUT and FSRH Diploma
Practical training and support for GPs and nurses who wish to gain their letter of competence in intrauterine techniques (LoC IUT) and complete the faculty of sexual and reproductive healthcare (FSRH) diploma.
PP-PF-WHC-IUS-GB-0060 | February 2024