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Review IUD Medical Information

Please make sure that the IUD type you are interested in is the best option for you.  IUDs vary by size and hormone content.  Your Arbor ObGyn physician or nurse practitioner should have provided you with a manufacturer’s brochure about the IUD.  If you did not receive it, or need additional information, please refer to the manufacturer’s website:

Review Your Insurance Benefits

Once your Arbor ObGyn provider requests it, your insurance carrier is contacted to obtain benefits for the IUD device requested and its insertion and/or replacement.  Arbor purchases the IUD and your insurance reimburses us at a contracted rate.  The IUD cost and the actual insertion/removal procedure are separate charges.  Once obtained, your IUD benefits are sent to you via a separate message located in your Patient Portal.  Please log in to the Patient Portal to review.

Arbor ObGyn uses ultrasound guidance at almost every IUD placement to identify the size, shape, and angle of your uterus.  This allows a safer placement procedure to reduce the risk of uterine perforation or suboptimal placement.  Ultrasound guidance may not be a covered benefit of your insurance at either the time of placement.  Please check with your insurance carrier if you would like to know your obligated costs.

There is usually no separate office visit charge in addition to the charge for the IUD placement.  Your 4-8 week follow-up visit is considered an office visit however, and will require your standard co-pay as determined by your insurance carrier.

We can both remove and replace an IUD at a single appointment.  We can remove (only) an IUD at an annual wellness appointment.  However, be aware that insurance carriers will not pay for insertion of a new IUD at the time of your annual gynecologic wellness appointment.

Insurance pre-authorization is not required, but we do contact and carefully review insurance benefits as a courtesy to you.  On rare occasions an Insurance Carrier may not pay as quoted.  Therefore, you may consider contacting your Insurance Carrier directly to confirm the information we have been given, and that it will be valid on the date of the IUD procedure.  If your insurance claim is denied for any reason after the device is placed you will still be responsible for fees which will exceed $1,000.  The billing codes are:  IUD Insertion (58300), IUD Removal (58301), Ultrasound Guidance (76998), Ultrasound follow-up (76857), Mirena IUD (J7298), Kyleena IUD (J7296), Skyla IUD (J7301), Paragard IUD (J7300).

Schedule an Appointment for Placement of the IUD

Before you call, please review the preparation information below so that your appointment can be appropriately timed with regards to your menstrual cycle.  Once you also have reviewed your insurance benefits Patient Portal message, simply reply to the message indicating your desire for the IUD placement.  Please list some dates & times that would work for placement.  Please replay with a good phone number and time to reach you so that we can call you to schedule the placement.

Preparation for Your IUD Placement Appointment

Carefully review the information below so that your IUD placement appointment is correctly scheduled, and so that Arbor ObGyn will not cancel your procedure when you arrive.

Pregnancy Precaution

Placement of an IUD at the time of an unknown early pregnancy could cause miscarriage or complications with the pregnancy.  It is important that you take precautions to ensure that you are NOT pregnant at the time of your appointment.  Please make sure that you use effective contraception with any sexual activity for the two weeks prior to your IUD placement.  Your IUD will not be placed if you have sex without contraception within two weeks.  “Breastfeeding”, “withdrawal”, and “natural family planning” for example are NOT considered contraceptive methods in preparation for IUD placement because of the high unintended pregnancy rates.  If you are not using contraception (condoms, pills, etc.) then simply do not have sex for two weeks before your appointment.

Timing with Menstruation

It is our preference to place the IUD either during or shortly after your menstrual cycle.  The cervix is generally slightly more open at this time allowing a more comfortable procedure.  In addition, this also helps to ensure that the IUD is not placed during an unexpected pregnancy.  If you have predictable and regular menstrual cycles, please call to schedule your IUD during this time window.  If you do not have predictable cycles, please wait until your cycle comes and call on the first day so that we can schedule it soon after.  If you are post-partum, breast-feeding, or don’t have menstrual cycles we can place it at any time.  If you already have an IUD in place, it can be removed/replaced at any time.

Medication Before You Arrive

Taking an anti-inflammatory pain medication such as over-the-counter ibuprofen 600-800 mg (Motrin, Advil) can reduce discomfort during an IUD placement.  Please take this medication with food approximately one hour prior to your procedure.  For selected patients your provider may have prescribed an additional medication such as misoprostol (Cytotec) orally on the morning of the procedure.  Follow the instructions on the prescription bottle.

You should expect to be in the Arbor ObGyn office for approximately 30 minutes.  A urine pregnancy test is required when you arrive.  The pelvic exam, ultrasound, and IUD placement takes about five minutes.  You may drive home by yourself.

Information for After Your IUD Placement

Pain

It is normal to have some cramping during and following placement.  Ibuprofen can be used as needed for next few days.  If pain becomes too severe or you develop a fever above 100.4, please contact the office.

Bleeding

It is very common to have bleeding after IUD placement.  Irregular bleeding can continue for 3-6 months in some cases.  The majority of patients continue to report some occasional spotting at the follow-up visit.  With the Paragard you should continue to have regular and normal-flow monthly cycles, although the first few menstrual cycles may be somewhat heavier than you are accustomed.  The Mirena, Kyleena, and Skyla are expected to slowly lighten your periods.  If you have prolonged bleeding after placement please contact the office.

Sexual Activity

Do not have sex for 24 hours after the IUD insertion.  This can reduce your chance of a uterine infection.  It is important to use condoms for contraception with any sexual intercourse during the first week after IUD placement, to reduce the chance of unintended pregnancy.  All IUD types will be effective at preventing pregnancy after one week.  You and your partner should not feel the presence of the IUD or strings during sexual intercourse.  The strings will slowly soften and bend around the face of the cervix so that they don’t stick straight out.  We will check the strings at your follow-up exam.

Infection Precautions

IUDs do not prevent sexually transmitted diseases.  Please continue to use safe sex practices which include condoms and monogamy.  If you are concerned that you may have been exposed to a sexually transmitted infection please contact our office so that we can properly evaluate you.

Unintended Pregnancy

IUDs are extremely effective in preventing pregnancy.  If you find out that you are pregnant, however, please contact our office right away so that we can evaluate you.  Pregnant women who already have an IUD are more likely to have an ectopic (tubal) pregnancy, which can be life-threatening.

Follow up

A 4-8 week follow-up appointment will be scheduled following placement.  It is important that you come for this appointment.  A pelvic exam will allow determination of the appropriate string length.  An ultrasound may be performed as well.  If possible it is preferable that you learn to check the IUD strings each month after your cycle has ended to help confirm ongoing proper placement.  If you cannot feel them or if they feel much longer than expected, please contact our office for an appointment.

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