Background: Intrauterine devices (IUDs) are contraindicated in patients with known uterine anomalies, eliminating an extremely effective contraceptive option. However, data regarding contraceptive desires in these patients are limited to a few case reports.
Case: A 20-year-old nulligravida with a uterus didelphys desired contraception after oral contraceptive pills and an etonogestrel implant failed. Despite extensive counseling, including Centers for Disease Control and Prevention guidelines regarding contraindications for IUD placement in the setting of a uterine anomaly, she desired to proceed with placement of 2 IUDs. Two 13.5-mg levonorgestrel IUDs were successfully placed into each uterine horn.
Summary and conclusion: In select patients with uterine anomalies, IUD placement can be a safe and effective option. This is especially important in adolescents who might be at increased risk for unintended pregnancy and poor obstetric outcomes.
Keywords: Congenital abnormalities; Contraception; Hormonal contraception; Intrauterine device; Uterine anomalies.
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