Migration of intrauterine contraceptive device

Last revised by Dr Yair Glick on 24 Jun 2022

Migration / displacement of an intrauterine contraceptive device is one of the complications that can occur with an intrauterine contraceptive device (IUCD). It can represent either an intra-uterine or extra-uterine migration.

Most intrauterine contraceptive devices are normally positioned in the fundal region.

The accepted orientation depends on the type of device but in the case of a standard T-shaped device, the stem normally extends toward the cervix with the two arms fully unfolded, reaching laterally toward the uterine cornual regions. A change in this position in terms of location can be interpreted as a migration.

If an IUCD passes completely through the external cervical os, it is then termed an IUCD expulsion.

Low IUCDs, however, can spontaneously migrate back to the fundus after a few months.

Radiographic features / assessment

A migrated intrauterine conceptive device can be assessed and monitored on multiple imaging modalities, with ultrasound being considered the commonest modality of choice.

Ultrasound 

On ultrasound, the stem of a standard T-shaped IUCD is usually easily identified as a linear echogenic structure within the endometrium when in normal position. This position changes with migration.

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Cases and figures

  • Case 1
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  • Case 2: extra-uterine migration of Lippes loop
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