At what time of menstrual cycle IUCD device may be fitted ??

 Timing of insertion of IUCD if she comes to your OPD/ PHC on day 25^th of  her cycle having unprotected sex in that cycle; your position to insert the device or not on that day ?? : When to get an IUD fitted? Any time when couple decides and she is not pregnant (UPT-ve). Why hesitate, she may not come again to you. Put an device and ask her to consume Emergency pill in your presence, I hope it is that easy. What is the members take on this dual protection on pregancy? Timing of insertion of IUCD if she comes to your OPD/ PHC on day 25^th of  her cycle having unprotected sex in that cycle; your position to insert the device or not on that day ?? : When to get an IUD fitted? Any time when couple decides and she is not pregnant (UPT-ve). Why hesitate, she may not come again to you. Put an device and ask her to consume Emergency pill in your presence, I hope it is that easy. What is the members take on this dual protection on pregancy?

A)           With no evidence of recent pregnancy –

a) Within twelve days of commencement of menstrual period : A woman can be fitted with IUD within first twelve days of commencement of menstrual bleeding. The device offers immediate protection and no additional protection is required in that cycle even if she had unprotected sex in that cycle prior to the insertion of IUD.

Probability of an existing pregnancy is extremely low before day twelve of the menstrual cycle, based on the extremely low risk of ovulation before day eight and the 5-to-7day emergency contraceptive coverage effect of copper bearing IUDs.

b)Any day of menstrual cycle : IUD can also be inserted at any time during menstrual cycle at her convenience if she is reasonably certain that she is not pregnant i.e. either she had no coitus in that cycle or had coitus with due protection e.g. condom or were under cover of oral pills.

c)  During amenorrhea provided urine test for pregnancy is negative: Amenorrhea i.e. cessation of menstrual period six months a beyond may be due to pregnancy, lactation or due to some gynecological, endocrine or nor commonly psychological facts. IUD can be fitted if amenorrhea is due to endocrine, psychological or local (uterine) cause and no harm will result. But results from international clinical trials do not confirm this belief and IUD insertion is quite safe six weeks after childbirth. The only care that HCP (Health Care Providers) should exercise is that uterine size must be determined carefully by bimanual examination and by passing a uterine sound (a thick flexible wire) into the uterus. Because at this stage womb is often small, therefore, a small sized IUD like ML Cu 250 (short), ML Cu 375 (short) or NOVA T (if available) may be the better choice. Standard size IUDs may however be chosen in lactation period, after resumption of menstrual period.

d)Emergency IUD insertion as post-coital contraceptive: Use of copper containing devices as emergency contraception is safe and effective and can help prevent unintended pregnancy if used within 120 hours of unprotected intercourse. Emergency contraceptive pills (ECPs) containing only levonorgestrel are also effective and have fewer side effects.