IUDs and Miscarriage: Risks Even After Removal?Katlyn Joy |20, March 2014
The Mirena device is used by 2 million women each year in the US, and by 15 million women worldwide. It is an IUD, or intrauterine device that prevents pregnancy for up to five years and uses a chemical, levonorgestrel, a progestin hormone often found in birth control pills. It does not contain estrogen, however. Its success rate rivals sterilization methods, at 99%.
How it Works
According to the company website, the exact mechanism that prevents pregnancy is unknown, but they list a group of possible factors that may work together to stop pregnancy from occurring.
- The lining of the uterus is thinned.
- Cervical mucus is thickened.
- Sperm is inhibited from entering cervix.
- It may prevent ovulation.
Are IUDs a Cause for Infertility?
Ads on TV announce possible links between Mirena and various complications such as ectopic pregnancy, uterine perforation, miscarriage, embedment of the device, ovarian cysts, bleeding, migration of the device outside the uterus and possibly into other organs.
There are a number of lawsuits going on against the parent company, Bayer. However, a new suit is looking at something largely overlooked previously and that is whether the risks from Mirena may continue even after removal.
Specifically, a case out of Kansas involves a woman who had the device implanted in 2011 and kept it in place a few years in order to add to their family, having already given birth to a son. This is when the family began to be concerned that Mirena had more serious risks than they knew. In her first pregnancy, pre-Mirena, she became pregnant easily and had a complication-free pregnancy. She suffered no miscarriages. Post-Mirena has been a different story, however. The woman has had three miscarriages in one year, with no lab work or tests showing any fertility issues.
She has now sought help at a fertility clinic and remarks that a number of doctors suspect Mirena to be the root cause of her inability to carry a pregnancy to term now. While no hard research has been done on whether this could be a factor in infertility after using the device, it is notable that the Mirena device costs users an average 0.
What Mirena Says about Risks
Mirena's website warns the device isn't for everyone. The following are reasons not to use the IUD.
- Possible pregnancy.
- Current pelvic infection.
- Have had PID, or pelvic inflammatory disease.
- Immune system is weakened.
- Have more than one sexual partner, or a partner who has other sex partners.
- Unexplained vaginal bleeding.
- Liver tumor or disease.
- History of breast cancer.
- Uterine issues such as fibroid tumors.
- Allergies to levonorgestrel, silicone or polyethylene.
- IV drug use.
- History of pelvic infection within few months of pregnancy.
Other Risk Factors that May Preclude Using Mirena
Other things you need to discuss with your physician before implanting Mirena:
- History of heart attack or stroke, whether suspected or confirmed with a diagnosis.
- Problems with blood clotting, or treatment for it.
- Recently gave birth.
- Severe migraines.
- Congenital heart disease or heart defects.
- Long-term use of corticosteroid medications.
Serious but Uncommon Side Effects or Risks
The risk of PID is greatest in the first 20 days following placement of Mirena. This occurs in less than 1 percent of women using Mirena.
Rarely, a severe life-threatening infection can occur immediately following insertion of the device, within the first few days. This infection called sepsis has been identified in 9 users.
Embedment of the device in the uterine wall, which means it will no longer prevent pregnancy and will need reimplantation.
Perforation of the uterine wall is serious, and may cause infection, scarring, or organ damage. Surgery may be required to repair damage as well.
If you become pregnant while it's in place, you can have an ectopic pregnancy. If the pregnancy implants normally, it is still a life threatening situation which will require the device to be removed, which may cause miscarriage. However, it is necessary since leaving it in place throughout pregnancy may cause death.
Talk to your physician about your family planning decisions, including your long-range plans. In light of what we don't yet know, you may want to delay using a device such as Mirena until you've reached the family size you believe you desire.
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