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Use of Two Levonorgestrel Intrauterine Devices in a Patient with a Uterus Didelphys: A Case Report

  • Kathleen O'Brien
    Affiliations
    University of Michigan Department of Obstetrics and Gynecology, Ann Arbor, Michigan
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  • Colin Russell
    Affiliations
    University of Michigan Department of Obstetrics and Gynecology, Ann Arbor, Michigan
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  • Author Footnotes
    # Present address: Section of Pediatric and Adolescent Gynecology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205.
    Y. Frances Fei
    Footnotes
    # Present address: Section of Pediatric and Adolescent Gynecology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205.
    Affiliations
    University of Michigan Department of Obstetrics and Gynecology, Ann Arbor, Michigan
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  • Monica W. Rosen
    Correspondence
    Address Correspondence to: Monica Rosen, M.D., University of Michigan Department of Obstetrics and Gynecology, 1500 E. Medical Center Dr, Ann Arbor, MI 48109; Phone (734) 615-3773; Fax (734) 647-9727.
    Affiliations
    University of Michigan Department of Obstetrics and Gynecology, Ann Arbor, Michigan
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  • Author Footnotes
    # Present address: Section of Pediatric and Adolescent Gynecology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205.

      ABSTRACT

      Background

      Intrauterine devices (IUDs) are contraindicated in patients with known uterine anomalies, eliminating an extremely effective contraceptive option. However, data regarding contraceptive desires in these patients are limited to a few case reports.

      Case

      A 20-year-old nulligravida with a uterus didelphys desired contraception after oral contraceptive pills and an etonogestrel implant failed. Despite extensive counseling, including Centers for Disease Control and Prevention guidelines regarding contraindications for IUD placement in the setting of a uterine anomaly, she desired to proceed with placement of 2 IUDs. Two 13.5-mg levonorgestrel IUDs were successfully placed into each uterine horn.

      Summary and Conclusion

      In select patients with uterine anomalies, IUD placement can be a safe and effective option. This is especially important in adolescents who might be at increased risk for unintended pregnancy and poor obstetric outcomes.

      Key Words

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