Abstract
EVIDENCE-BASED ANSWER Risk of pelvic inflammatory disease (PID) does not differ between same-day or delayed insertion for women without overt cervicitis (SOR: A, meta-analysis of RCTs and prospective cohort). Same-day insertion increases probability of continued IUD use compared with delayed insertion. However, women with same-day insertion after an induced or spontaneous abortion are more than twice as likely to have IUD expulsion than women with delayed insertion (SOR: A, meta-analysis of RCTs). Return rates for a subsequent appointment for IUD insertion are as low as 54% (SOR: B, cross-sectional study). Delaying IUD placement for sexually transmitted disease testing is discouraged in asymptomatic patients (SOR: C, consensus opinion).
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