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Missing IUD threads — DFSRH MCQ

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EasyIntrauterine contraceptionMissing IUD threadsDFSRH

A 34-year-old copper IUD user cannot feel her threads. She has no pain or bleeding and a urine pregnancy test is negative. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Speculum examination followed by ultrasound if threads are not seen

Missing threads require assessment, starting with examination and then ultrasound if not visualised. Pregnancy should be excluded. Blind removal attempts are inappropriate.

Reference: FSRH Intrauterine Contraception Guideline 2023; UKMEC 2025; BNF