How is the copper T380A IUD (Paraguard) inserted?

Updated: Nov 29, 2018
  • Author: Sarah Hagood Milton, MD; Chief Editor: Christine Isaacs, MD  more...
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Answer

Answer

The copper T380A packaging is opened by an assistant, taking care to maintain the sterility of the package contents.

Load the IUD into the insertion tubing. This is accomplished by slightly withdrawing the insertion tubing and folding the horizontal arms of the IUD down along the vertical arm using your thumb and index finger. The insertion tubing is then advanced so that the horizontal arms sit securely within the insertion tubing. See the images below.

Loading the copper T380A IUD into the insertion tu Loading the copper T380A IUD into the insertion tubing.
Loading the copper T380A IUD into the insertion tu Loading the copper T380A IUD into the insertion tubing.

Next, the solid white rod is introduced into the bottom of the insertion tubing and advanced to the point that it touches the bottom of the IUD (see the image below).

Placing the insertion tubing containing the copper Placing the insertion tubing containing the copper T380A IUD.

The insertion tube is grasped at the open end and the blue flange is set to the level to which the uterus sounds. The insertion tubing is then rotated so that the horizontal arms of the IUD are parallel to the long axis of the blue flange. See the image below.

Releasing the arms of the copper T380A IUD. Releasing the arms of the copper T380A IUD.

The loaded insertion tube is passed through the cervical canal until resistance is met at the uterine fundus and the blue flange should be at the external cervical os, as shown in the image below.

Advancing the insertion tubing to the fundus, wher Advancing the insertion tubing to the fundus, where slight resistance is felt.

With the solid white rod steady, the insertion tubing is withdrawn approximately 1 cm, releasing the IUD.

The insertion tube is then gently moved up to the fundus of the uterus, ensuring placement of the IUD at the level of the fundus. Holding the insertion tubing steady, withdraw the white rod. Then, gently withdraw the insertion tubing. See the image below.

Holding the insertion tube steady and withdrawing Holding the insertion tube steady and withdrawing the white rod.

Following removal of insertion device, the IUD strings will be readily visualized in vagina. Using long-handled scissors, the strings are then trimmed so that approximately 3 cm are visible extending, from the external cervical os. [53] See the image below.

Trimming the IUD strings. Trimming the IUD strings.

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