Incidence of perforation with intrauterine devices

When available and used properly, intrauterine devices (IUDs) are near-perfect birth control as they provide highly effective protection against pregnancy with minimal to no adverse systemic side effects. [...]patient satisfaction rates are high.1 Given these successes, IUD provision has markedly expanded.2,3 In many contraceptive markets globally, new IUD doses and sizes have been added recently. The unique cohort represented in this database allows the time of patient follow-up to be remarkable, with a median follow-up after IUD insertion of 1·4 years (IQR 0·5–3·0), and over 29 000 patients contributing data at 5 years, including over 7000 patients in the post-partum cohort. Since uterine perforation is a rare event, these large numbers are necessary to provide accurate risk assessments. [...]assessment of uterine perforation risk specific to each IUD type would further improve patient counselling regarding risk.