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On IUD. Feeling tired and pain. Suggested for surgery. Is it safe to wait or should go for surgery?

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Practicing since : 1999
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My daughter, age 26 had an IUD put in about seven months ago. She was unhappy with it, side effects being moody and tired and intermittent pain. She went to one doctor who told her it was out of place and she should remove it and that he would do it, but he wasnt her regular doctor so she went to her regular one who tried to remove it but said it was embedded lower down and suggested surgery/ and or a D&C. We went to a clinic that does those procedures but when he did the ultrasound he wasnt sure if he saw it or not and therefore couldn't be sure the D&C would work, so she didnt have the procedure done. Now we are unsure what to do and who exactly to go to and worse she has been having sharp pains since this last visit and her regular doctor is out of town until maybe tuesday. Is it safe to wait or should she go to an ER right away?
Posted Sat, 4 Aug 2012 in Birth Control
Answered by Dr. Timothy Raichle 23 minutes later
Hello, I would be happy to help you today.

There is definitely concern about this IUD, even going back to when it was placed. The fact that she had intermittent pain makes me concerned that it was never in the right place to begin with. In addition, you have one doctor who was unable to remove it because it was "embedded" and another doctor who could not even see it on ultrasound!

These are not hard to see on ultrasound (when performed through the vagina) so in my mind there are three possibilites:

1. The IUD is in fact embedded in the uterus in a way that makes it difficult to see on ultrasound
2. The IUD fell out through the vagina
3. The IUD is not in the uterus, but in the abdomen

I have never had this happen to me personally with a patient, but I have surgically removed them from the belly several times. My recommendation would be to go to the ER and have them evaluate your daughter (waiting for her doctor is not necessary and might be unsafe). A simple belly XRAY will easily show about where it is.

In addition, there is concern that if it is not in the uterus, then she has been at risk for pregnancy during this entire time - she needs to have a pregnancy ruled out as well with a blood test.

I hope this helps. Good luck!!
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