IUC Fitting




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Preparing for the insertion of an intrauterine device (copper IUD) or an intrauterine system (Mirena)

We want to make your clinic visit as straightforward as possible and fit the IUD/IUS at a single appointment. Therefore, it is important that you have read all the information and are suitable for the procedure on the day you come. You can also discuss other methods with us and ask any questions. Please bring this form with you when you attend the clinic.

Personal Details
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Please tick the boxes to confirm that you have understood and agreed to the following:
  • I understand that it is not safe to insert an IUD/IUS if I might be pregnant:

    • I am using an effective method of contraception and have NOT had any problems (such as a burst condom, missed pills, IUD/implant overdue for change). 

    • OR I have not had unprotected sex (or used withdrawal) since my last period. 

    • OR I don’t have regular periods and I haven’t had any unprotected sex for the last 3 weeks.

  • If I am having an IUS/IUD re-fitted I will make sure I have not had unprotected sex in the last 7 days.
  • I will make sure that I have had breakfast/lunch on the day of the appointment. A painkiller can be taken around an hour in advance.
  • I am not at risk of sexually transmitted infection (eg I do not have a new partner) or I have been tested recently for chlamydia / gonorrhoea.

  • I understand that no method is 100% effective and that the IUD/IUS has a very small risk of failure (less than 1 in 100 chance of pregnancy).

  • I understand that there is a 1 in 1000 risk of perforation of the womb at the time of insertion of the device
  • I understand that there is a 1 in 20 chance of the device falling out.
  • I understand that the IUS/IUD will not protect against sexually transmitted infections and condoms in addition are recommended for this if for example I have a new partner.

  • I understand that there is a small risk of infection (1 in 100) in the first few weeks following insertion of a device.

  • I know that a copper IUD will make my periods heavier, longer and more painful.

  • I know that an IUS (Mirena) will make my periods much lighter but causes erratic bleeding and spotting in the first few months of use.

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