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Completed

NCT Number: NCT00737178

Immediate Versus Delayed Insertion of the Copper Intrauterine Device (IUD) After Medication Abortion

After medication abortion, women may quickly become pregnant again and therefore need an effective birth control method right away. Intrauterine devices (IUDs) are very effective for preventing pregnancy. IUDs are usually placed more than a month after abortion. This study will randomly assign women having a medication abortion to two groups, either having the IUD inserted one week after medication abortion or having the IUD inserted more than four weeks later. Women will be followed for six months to compare how many return for IUD placement in the two groups, how many are using the IUD after six months, experience with pain, bleeding, and cramping, how easy or difficult it is to insert the IUD, how many IUDs are expelled or removed, and how many women are using any birth control six months after the abortion.

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Key information

Conditions

Contraception

Age range

18 year and older

Sex eligibility

Female

Study type

Interventional

Phase

Phase 4

Primary location

Special Gynecology Services

New York, 10032, United States

About this study

Women presenting for medication abortion are highly motivated to initiate contraception and are also at high risk for repeat pregnancy. Intrauterine devices (IUDs) are among the most effective reversible methods. IUD insertion is routinely planned for at least four weeks after medication abortion. This leaves women vulnerable to pregnancy while waiting for IUD placement, and many will not return for this visit. While immediate IUD insertion after surgical abortion is known to be safe and effective, it has not been studied after medication abortion.

This study will recruit women undergoing medication abortion at Special Gynecology Services who desire an IUD for contraception. Women will be randomized to two groups: immediate insertion of the copper IUD at the routine one week follow up visit, or delayed insertion of the copper IUD at least four weeks after the medication abortion.

The primary objective of this study is to compare six month IUD prevalence between the immediate and delayed IUD insertion groups. Secondary outcomes include comparison of IUD insertion rates, continuation rates, expulsion and removal rates, and use of any contraception at six months. Pain experienced during insertion and provider ease of insertion will be recorded. A diary collected for four weeks following medication abortion will reveal the impact of early IUD placement on bleeding and cramping. Lastly, we will correlate endometrial stripe thickness and IUD position to outcomes of interest: continuation, expulsion, and removal rates.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Undergoing medication abortion
  • 18 or older
  • Desires IUD as birth control method for a minimum of six months
  • Speaks Spanish or English
  • Has a working phone number or pager
  • Is willing to attend visits and will be in the area for next six months
  • Has signed informed consent

Exclusion criteria

  • Chlamydia, gonorrhea, or pelvic inflammatory disease within the past three months
  • Known bleeding diathesis including anti-coagulation
  • Uterine abnormality including sub-mucous myomas that significantly distort the uterine cavity
  • Current cervical, uterine, or ovarian malignancy
  • high-grade squamous intraepithelial lesion on most recent pap
  • IUD insertion contraindicated by the World Health Organization's Medical Eligibility Criteria for Contraceptive Use (category 3 or 4)

Treatment and study plan

CuT380A

Device

Comparison of different timing of IUD insertion

Other names: IUD, Copper T

Primary outcomes

  1. Use of the IUD for Contraception at Six Months

    Time frame: 6 months

    Six months after enrollment, we determined whether or not women were using the IUD through in-person exit interviews and phone interviews. This was an intention to treat analysis, comparing the proportion of women using the IUD based on their group assignment (immediate or delayed).

Secondary outcomes

  1. Insertion Rates

    Time frame: By six months after medication abortion

    Insertion rates are the proportion of women in each allocation group (immediate, delayed) who ultimately had the IUD inserted within the 6 month study period.

  2. Expulsion and Removal Rates

    Time frame: Within six months of medication abortion

    Expulsion rates were defined as the number of IUDs expelled from the uterus among participants who had the IUD inserted during the study.

    Removal rates were defined as the number of IUDs that were electively removed by participant request among participants who had the IUD inserted during the study.

Sponsors and collaborators

Lead sponsor

Columbia University

Other

Registry information

Official study title

A Randomized Trial of Immediate Versus Delayed Insertion of the Copper T380A Following Medication Abortion

Important dates

Study start
2008
Primary completion
2009
Study completion
2011
First posted
Aug 18, 2008
Registry last updated
Sep 19, 2014

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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