Levonorgestrel-Releasing Intrauterine System and Pregnancy

Levonorgestrel-Releasing Intrauterine System and Ectopic Pregnancies

An ectopic pregnancy occurs when the embryo implants outside the uterus (womb), usually in one of the fallopian tubes (the tube that carries the egg from the ovary to the uterus). For this reason, ectopic pregnancies are sometimes called tubal pregnancies.
An ectopic pregnancy is a medical emergency that often requires surgery. The pregnancy cannot proceed as normal, and the fetus is unable to survive. If not treated, it may cause permanent damage that leads to infertility or other serious problems, such as internal bleeding.
Although pregnancy is exceedingly rare for a woman using levonorgestrel-releasing intrauterine device, up to half of pregnancies that occur with the medication are ectopic pregnancies. It is important to report any signs of an ectopic pregnancy to your healthcare provider right away. Such signs may include severe abdominal (stomach) pain and unusual vaginal bleeding.
Women who have had an ectopic pregnancy, tubal surgery, or pelvic infection have a higher risk for this complication. Let your healthcare provider know if these conditions apply to you.

Levonorgestrel-Releasing Intrauterine System and Nonectopic Pregnancies

Levonorgestrel-releasing intrauterine system can also cause problems if the pregnancy is in the uterus. Leaving the device in place during pregnancy can cause serious infection, miscarriage, and premature birth. In addition, the developing fetus will be directly exposed to levonorgestrel, the hormone released by the device. At this time it is unknown if the exposure to levonorgestrel increases the risk of birth defects or other problems in the fetus.
Because of the possible risks, it is recommended that the device be removed during pregnancy. However, removal can also cause miscarriage. If the device cannot be removed, you and your healthcare provider will need to discuss the risks and benefits of continuing the pregnancy. If you choose to continue the pregnancy, you will need to see your healthcare provider regularly to be closely monitored.
Last reviewed by: Kristi Monson, PharmD
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