Should the IUD be removed early to prepare for pregnancy?

Question

Hello doctor,

I had a copper intrauterine device inserted a year ago for birth control. While it has been effective, I have started having heavier periods and more cramps than usual. I am now thinking about switching to a hormonal intrauterine device, but I am concerned about how the hormones might affect my mood, weight, or future fertility. I also have polycystic ovary syndrome and wonder if a hormonal intrauterine device could help manage some of its symptoms. My partner and I are also discussing the possibility of starting a family in the next one to two years. Should I remove the intrauterine device early to help prepare my body for pregnancy?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

The copper intrauterine device can sometimes cause heavy bleeding, although it more commonly results in lighter menstrual flow. If you start experiencing heavy bleeding while the copper intrauterine device is in place, it is important to have a pelvic ultrasound scan. This scan will help check for any abnormalities in the uterus, such as fibroids, adenomyosis, or endometrial polyps, which could be responsible for the increased bleeding and cramping. I recommend that you undergo a pelvic ultrasound to help determine the most likely cause.

Since the copper intrauterine device does not contain hormones, fertility usually returns immediately after it is removed. Therefore, if you are planning to start a family, you can consider removing it about one month before trying to conceive. If the ultrasound does not reveal any uterine masses, then the copper intrauterine device is likely the cause of the heavy bleeding.

Switching to a hormonal intrauterine device might be a helpful alternative. Hormonal intrauterine devices mainly act locally in the uterus and usually have minimal side effects, such as mild mood changes or slight weight gain. They do not affect long-term fertility, and most women regain fertility within one to three months after removal. For now, it is best to proceed with the pelvic ultrasound scan and then decide the next steps based on the results.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.