Is it safer to remove or keep the IUD during pregnancy?

Question

Hello doctor,

I am 30 years old and approximately five weeks pregnant. However, I had a copper intrauterine device (IUD) in place at the time of conception. I visited my obstetrician-gynecologist (OB-GYN), and they informed me that the IUD is still inside the uterus but is difficult to remove. I am very scared about the potential risk of miscarriage if the IUD remains in place or if there is an attempt to remove it. What is usually done in cases like this? How dangerous is it to keep the IUD in during pregnancy?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Congratulations on your pregnancy. I understand how stressful this situation must feel. Pregnancy with a copper intrauterine device (IUD) in place is uncommon, but it does happen, and your concerns are absolutely valid. When a pregnancy occurs with an IUD still in place, the ideal approach is usually to remove the IUD as early as possible, if the strings are visible and removal can be done safely without disturbing the pregnancy. Studies show that leaving the IUD in place increases the risk of miscarriage, infection (such as chorioamnionitis), and preterm birth, particularly as the pregnancy progresses. However, removal also carries a small risk of miscarriage, especially if the IUD is embedded or the strings are not easily accessible. In your case, since your obstetrician-gynecologist (OB-GYN) mentioned that the IUD is still present but difficult to remove, it likely means: The IUD is either embedded in the uterine wall or located high up in the uterus, beyond easy access.

Attempting removal might pose a greater risk than leaving it in place, especially this early in pregnancy.

What typically happens in situations like yours: Your OB-GYN will closely monitor the pregnancy with ultrasounds, especially to confirm that it is intrauterine (not ectopic) and to track fetal development and any signs of complications.

If the IUD cannot be safely removed, you will be followed more closely than usual during pregnancy to monitor for infection, bleeding, or signs of preterm labor.

If you experience any symptoms such as cramping, bleeding, fever, or unusual vaginal discharge, it is very important to seek immediate medical care.

The exact level of risk varies depending on where the IUD is located and how your body responds, but some women do go on to have successful pregnancies even with the IUD left in place. Your OB-GYN will guide you through the safest course of action based on your specific circumstances. For now, it is a matter of careful monitoring, and you are doing the right thing by staying informed and seeking care early.

I hope this helps. Thank you.