“My IUD is expiring”: A national U.S. mystery client study regarding use of the LNG 52-mg IUD for pregnancy prevention beyond five years after multiple FDA extensions

Abstract

ObjectiveSince 2020, the FDA has approved multiple extensions to the use of the levonorgestrel (LNG) 52-mg intrauterine device (IUD) for pregnancy prevention beyond five years. The accessibility of this information to patients calling a reproductive health clinic to schedule replacement remains unknown. We assess the patient experience in accessing information via phone call to a clinic on the duration of pregnancy prevention for LNG 52-mg IUD. Study DesignWe utilized a mystery client study design before and after the 2022 extension to inquire about LNG 52-mg IUD use beyond five years. Purposeful sampling ensured clinic diversity. ResultsIn June 2022, 18 (32%) clinics offered extended use beyond five years, 25 (44%) recommended replacement at five years, and 14 (25%) could not provide information. The number of clinics offering extended LNG 52-mg IUD use did not significantly increase in August 2023 (n=22, 39%, p=0.27). ConclusionPatients scheduling a replacement of the LNG 52-mg IUD may not receive information about use beyond five years. Reproductive health clinic’s scheduling staff need further training on updated guidelines.