Indications for removal of intrauterine contraceptive devices in Jos, north-central Nigeria

Abstract

Context: Intrauterine contraceptive devices (IUDs) are commonly used reversible methods of contraception. The CuT 380A is recommended for use for 10 years but common observation has shown that they are removed much earlier than the recommended duration ofuse.

Methodology: A retrospective study of all clients presenting at the family planning clinic of Jos University Teaching Hospital, between 1st January 1999 and 31st December 2004, for removal of their IUDs. MAJOR OUTCOMES/RESULTS: The mean (+/- SD) age of the clients was 32.9 +/- 6.9 years and mean parity was 4.0 +/- 2.2. All the women were married. The CuT 380A IUD was used in 99.3% of the cases. The mean duration of IUD use was 51.5 +/- 51.0 months or 4.3 years only, and the commonest indication for removal was the desire for another pregnancy, which was recorded in 170 (30.7%) of the clients. This was followed by back pain in 70 (12.6%). Husbands' disapproval of the use of the device was recorded in 0.9% of the clients.

Conclusion: The duration of IUD use by clients in our centre was very short. The commonest indication for removal of the device was to restore fertility. Shorter lasting IUDs may need to be revisited if these will cost less for clients wishing to use the method only to postpone pregnancies. More effective counselling may be appropriate for alternative contraceptive methods for this category of clients instead of the IUDs currently being used.