1. Insertion of the Mirena intrauterine system
Insertion of the Mirena intrauterine system. Initially, threads from behind the slider are first released to hang freely. The slider found on the handle should be positioned at the top of the handle nearest the device. The IUD arms are oriented horizontally. A flange on the outside of the inserter tube is positioned from the IUD tip to reflect the depth found with uterine sounding. A. As both free threads are pulled, the Mirena IUD is drawn into the inserter tube. The threads are then tightly fixed from below into the handle's cleft. In these depictions, the inserter tube has been foreshortened. The inserter tube is gently inserted into the uterus until the flange lies 1.5 to 2 cm from the external cervical os to allow the arms to open. B. While holding the inserter steady, the IUD arms are released by pulling the slider back to reach the raised horizontal mark on the handle but no further. C. The inserter is then gently guided into the uterine cavity until its flange touches the cervix. D. The device is released by holding the inserter firmly in position, and pulling the slider down all the way. The threads will be released automatically from the cleft. The inserter may then be removed and IUD strings trimmed.
Source: Chapter 32. Contraception, Williams Obstetrics, 23e
Citation: Cunningham F, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics, 23e; 2010 Available at: Accessed: October 15, 2017
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