What is the recommended follow-up schedule for patients after the insertion of an IUD, IUS, or implant?

Recommended follow-up schedule after insertion of an intrauterine device (IUD) or intrauterine system (IUS):

• Routine post-insertion check-ups are not required for both copper IUDs and levonorgestrel IUS devices.
• If the device was inserted within 48 hours of vaginal or caesarean birth, advise the woman to attend a review appointment within 4–6 weeks after insertion.
• Advise women to check for the threads of the device within the first 4–6 weeks after insertion and then at regular intervals (e.g., monthly or after menses).
• Women should be informed to seek urgent review if they experience symptoms of pelvic infection, concerns about bleeding patterns, a positive pregnancy test, persistent menstrual abnormalities beyond 6 months, mild lower abdominal pain with lost threads, discomfort during intercourse, or any other adverse effects.
• For suspected uterine perforation, wait at least 6 weeks before inserting subsequent intrauterine contraception and refer to a specialist service with ultrasound availability.

Recommended follow-up after contraceptive implant insertion:

• Contraceptive implants should be inserted and removed only by trained healthcare professionals.
• There is no routine requirement for scheduled follow-up visits after insertion unless the woman has concerns or adverse effects.

Additional advice includes providing women with information about their specific device, its mode of action, duration of use, time to become effective, and when to seek medical advice or removal.

These recommendations are based on the Faculty of Sexual and Reproductive Healthcare (FSRH) clinical guideline and NICE Clinical Knowledge Summaries (CKS) on contraception.

References: ¹,²