Progestin-Releasing IUD Insertion Technique
In this image: The Mirena instrument.
1. Release the IUD strings.
In this image: Release the IUD strings from behind the slider, allowing them to hang freely.
2. Position the slider.
In this image: Position the slider on the handle farthest away from you.
3. Align the IUD arms.
In this image: Rotate the arms of the IUD to be horizontal.
4. Draw the IUD into the tube.
In this image: Draw the IUD into the insertion tube by pulling on both strings; the arms fold upward and the knobs at the end of the arms cover the open end of the inserter.
In this image: Close up of the IUD drawn into the tube.
5. Fix the strings.
In this image: Fix the strings tightly in the cleft at the end of the handle.
6. Set the depth.
In this image: Set the flange equal to the measured depth of the uterus.
Inserting the progestin-releasing IUD:
Stabilize the cervix
Insert the inserter
Advance the inserter
Release the IUD arms
Re-advance the inserter
Release the strings
Remove the inserter
See detailed images below.
1. Stabilize the cervix.
In this image: Stabilize the cervix with the tenaculum, if necessary.
2. Insert the inserter.
In this image: Place the inserter into the cervical canal while holding the slider in the farthest position.
3. Advance the inserter.
In this image: Advance the inserter into the uterus until the flange is 1.5 to 2cm from the external cervical os.
4. Release the IUD arms.
In this image: Release the arms of the IUD by pulling the slider back to the mark on the handle.
5. Re-advance the inserter.
In this image: Hold the slider in position and advance the inserter gently until the flange touches the cervix; the IUD should be positioned at the uterine fundus.
In this image: Close up of the slider that is in position.
6. Release the strings.
In this image: Release the IUD strings by pulling the slider all the way back while holding the inserter firmly in position.
7. Remove the inserter.
In this image: Remove the inserter from the uterus. Cut the IUD strings to a length of 2-3cm.