Pregnancy while using a levonorgestrel-releasing intrauterine system 52 mg: a case report

Elvin Piriyev, Thomas Romer


Intrauterine contraception mostly in the form of copper intrauterine device (IUD) or hormone-releasing system, is a widely used method with a high level of contraceptive security. Despite high contraceptive efficiency, pregnancy can still occur. Pregnancy with a levonorgestrel-releasing intrauterine system (LNG-IUS) in situ is very rare. Intracavitary pregnancy with an IUD can lead to a higher risk of infection and preterm birth. Present the case of a 28-year old woman who was admitted to our hospital due to pregnancy with an LNG-IUS 52 mg in the 9th gestational weeks (8 weeks 3 days). Sonography showed an intact pregnancy corresponding to the gestational week. The IUS was located in the lower part of the cavity at a considerable distance from the amniotic cavity. After extensive information on the benefits and risks, sonography-guided saline infusion hysteroscopy was carried out. The intact pregnancy and the IUS could be shown hysteroscopically. The removal of the IUS was carried out with a grasping forceps. There was no complication. After an inconspicuous course of pregnancy, the patient spontaneously gave birth in 37 gestational weeks 1 day.


Risk pregnancy, LNG-IUS, Copper IUD, Pregnancy, Hysteroscopy

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Andersson K, Odlind V, Rybo G. Levonorgestrel-releasing and copper-releasing (Nova T) IUDs during five years of use: a randomized comparative trial. Contraception. 1994;49(1):56-72.

Backman T, Rauramo I, Huhtala S, Koskenvuo M. Pregnancy during the use of levonorgestrel intrauterine system. Am J Obstet Gynecol. 2004;190(1):50-4.

Benagiano G, Gabelnick H, Farris M. Contraceptive devices: intravaginal and intrauterine delivery systems. Expert Rev Med Devices. 2008;5(5):639-54.

Brahmi D, Steenland MW, Renner RM, Gaffield ME, Curtis KM. Pregnancy outcomes with an IUD in Situ: a systematic review. Contraception. 2012;85(2):131-9.

Chaim W, Mazor M. Pregnancy with an intrauterine device in situ and preterm delivery. Arch Gynecol Obstet. 1992;252(1):21-4.

Dominik B, Schneider J. Pregnancy and IUS. Geburtshilfe Frauenheilkd. 1997;57(12):687-8.

Ganer H, Levy A, Ohel I, Sheiner E. Pregnancy outcome in women with an intrauterine contraceptive device. Am J Obstet Gynecol. 2009;201(4):381:e1-5.

Heinemann K, Reed S, Moehner S, Minh TD. Comparative contraceptive effectiveness of levonorgestrel-releasing and copper intrauterine devices. Eu Active Surveillance Study IUD. Contraception. 2015;91(4):280-3.

Inal MM, Ertopçu K, Ozelmas I. The evaluation of 318 intrauterine pregnancy cases with an intrauterine device. Eur J Contracept Reprod Health Care. 2005;10(4):266-71.

Kim SK, Romero R, Kusanovic JP, Erez O, Vaisbuch E, Mazaki-Tovi S et al. The prognosis of pregnancy conceived despite the presence of an intrauterine device (IUD). J Perinat Med. 2010;38(1):45-53.

Sanders AP, Fluker MR, Sanders BH. Saline Hysteroscopy for Removal of Retained Intrauterine Contraceptive Devices in Early Pregnancy. J Obstet Gynaecol Can. 2016;38(12):1114-9.

Wallwiener M, Friedrich O, Schäfer K, Thum J, Eichbaum M, Rom J. Intrauterinpessare. Ultrasound in gynecology and obstetrics. Thieme, Stuttgart. 2013;3.