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Original Report| Volume 32, ISSUE 3, P312-315, June 2019

Intrauterine Device Insertion Procedure Duration in Adolescent and Young Adult Women

Published:January 09, 2019DOI:https://doi.org/10.1016/j.jpag.2019.01.002
Intrauterine Device Insertion Procedure Duration in Adolescent and Young Adult Women
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      Abstract

      Study Objective

      Intrauterine device (IUD) utilization in the United States is low among adolescent and young adult women. Longer procedure duration has been proposed as one potential barrier to IUD insertion in this population. We hypothesized that procedure duration would be longer in adolescents compared to young adult women.

      Design, Setting, and Participants

      This study was a secondary analysis of a randomized clinical trial comparing the effectiveness of a lidocaine vs sham paracervical nerve block for pain control during levonorgestrel 13.5 mg IUD insertion. Adolescent and young adult women ages 14-22 years were recruited from 3 outpatient academic sites in Philadelphia, Pennsylvania.

      Interventions and Main Outcome Measures

      Pain scores were recorded at 7 steps during the procedure from speculum insertion through removal. Time stamps associated with each step were used to calculate the overall procedure duration. Cumulative IUD insertion procedure duration was estimated using the Kaplan–Meier method.

      Results

      Ninety-five women enrolled. Nineteen (19/95, 20%) were ages 14-17 and 76 (76/95, 80%) were ages 18-22 years. The median procedure duration (seconds ± interquartile range) was longer for adolescents than for young adults (555 ± 428 seconds vs 383 ± 196 seconds; P = .008). After adjusting for study site, the difference in expected median procedure duration between age groups was not significant (P = .3832).

      Conclusion

      The difference in duration of IUD insertion procedures in adolescent and young adult women is not clinically or statistically significant. Providers should not withhold IUDs from appropriate adolescent and young adult women on the basis of age alone.

      Key Words

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      Article info

      Publication history

      Published online: January 09, 2019

      Footnotes

      A.Y. Akers is a consultant for the Merck HPV advisory board, and received less than $5000.00 in 2017 and anticipates receiving less than $10,000.00 in 2018. She is a member of the Reproductive Health Professionals HPV Advisory Board and receives less than $5000.00 annually ($2500.00 in 2016), did not receive money in 2017, and anticipates receiving less than $5000.00 in 2018. She is also a speaker for the Adolescent Reproductive and Sexual Health Education Project and she receives less than $5000.00 annually for this relationship. L.K. Perriera has been a consultant to Merck who trains health care providers to insert the Nexplanon contraceptive device, and receives less than $5000.00 annually. C.A. Schreiber receives research support from Medicines360 and Contramed. She served as a consultant for Berlex Pharmaceuticals in 2016. S. Sonalkar has been a consultant to the World Health Organization and is supported by the National Institutes of Health, United States Women's Reproductive Health Research Career Development Program (K12-HD001265-19). The remaining authors indicate no conflicts of interest.

      This study is registered at Clinicaltrials.gov (NCT02352714).

      Identification

      DOI: https://doi.org/10.1016/j.jpag.2019.01.002

      Copyright

      © 2019 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.

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