Response regarding an unusual shaped IUS
========================================

* Adam Forrest

*   intrauterine systems

I read with interest Dr MacGregor's letter1 regarding the unusual shape of a Mirena® intrauterine system (IUS) following removal. From the photograph it would appear that the capsule has become displaced and the arms of the device enclosed within it.

We have seen a case of complete detachment of the capsule from the frame, with unrecognised retention of the capsule within the uterine cavity. This was only recognised at hysteroscopy for investigation of subsequent infertility. This was described in a letter to the *British Journal of Obstetrics and Gynaecology* in 2008.2

It would seem prudent to check the integrity of the IUS at removal.

## Footnotes

*   Competing interests None.

## References

1.  MacGregor A. An unusual shaped IUS. J Fam Plann Reprod Health Care 2013;39:64.
    
    [FREE Full Text](http://jfprhc.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6MTQ6ImZhbWlseXBsYW5uaW5nIjtzOjU6InJlc2lkIjtzOjc6IjM5LzEvNjQiO3M6NDoiYXRvbSI7czoyOToiL2ZhbWlseXBsYW5uaW5nLzM5LzIvMTU0LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

2.  Forrest A, Amarakone I, Lord J. Retained hormone release capsule following removal of Mirena intrauterine system. BJOG 2008;115:130–131.
    
    [PubMed](http://jfprhc.bmj.com/lookup/external-ref?access_num=18053112&link_type=MED&atom=%2Ffamilyplanning%2F39%2F2%2F154.atom)