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If my Mirena IUD is embedded in the endometrium or myometrium, should I have it removed? #909/12

I have had the Mirena IUD without problems for 1 year. Recently there was an incident during sex that caused a brief sharp pain that was replaced with occasional mild pelvic discomfort. I then went to my gynecologist and had a transvaginal ultrasound that showed the IUD was in the fundus, but that one of the arms could not be visualized to the end and may therefore be embedded in the endometrium or myometrium. My gynecologist recommended having it removed.


Do I need to have it removed? Is there a risk of deeper embedding and problems with future removal or fertility? Is there a rush to remove it? It's already been almost 2 months since the incident.

If the arm of your Mirena is embedded into the myometrium (muscle) of your uterus, I would agree that it should be removed.


Was the insertion of your IUD quite painful?


Once removed, your Mirena IUD should not have any harmful effect on your future ability to become pregnant or to carry a pregnancy to term.


Her email reply on 9-29: “Dr. Hatcher, thank you for your reply.  The insertion was only painful when the arms were released, but I’m pretty sure it moved more recently.  The ultrasound couldn’t confirm it was embedded.  They just couldn’t follow the arm to the end.  I was hoping it didn’t have to be removed.  For all I know, the next one could become embed too and leaving this one in would save me two procedures!”


RAH’s reply on 9-30: From what you tell me you can leave it right where it is.


Her reply 9-30: “Really?  What changed your advice from the last email?”


RAH’s reply 10-5: What has changed is that you are now telling me that the ultrasound could NOT confirm that your IUD was embedded.  My bet would be that it isn’t.

RAH’s reply on 10-12: “How are you doing today? What have you decided to do?”

To learn more about the advantages and disadvantages of the Mirena IUD, go to our website

: www.managingcontraception.com and click on Choices.  You can also order this wonderful new educational book from our website or by calling 404-875-5001.  Do you have your copy yet?

Key Words:  Mirena IUD, incident, sharp pain, pelvic discomfort, gynecologist, transvaginal ultrasound, arms, visualized, embedded, endometrium, removed, risk, fertility, myometrium, painful, pregnancy, term, released, procedures

Posted 9-1, 2012, Updated 9-5-2012, Updated 10-6-2012, Updated 10-13-2012

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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