Review of clinical experience with the frameless LNG-IUS for contraception and treatment of heavy menstrual bleeding.
OBJECTIVE
Review the clinical experience with the frameless FibroPlant levonorgestrel intrauterine system (FP-LNG-IUS).


METHODS
An open, prospective non-comparative contraceptive 5-year study; a 1-year MBL study in women with heavy menstrual bleeding (HMB), using a PBAC and a 2-year MBL study in women with HMB and with normal menstruation using the quantitative alkaline hematin method. A literature review on perforation rate with the frameless GyneFix and FibroPlant.


RESULTS
304 insertions were performed with the FP-LNG-IUS. The total observation period was 11,299 woman-months. Only one pregnancy occurred. There were two expulsions and two uterine perforations at insertion during the first year. In the first 1-year MBL study, the median MBL decreased by more than 90%. In the second 2-year MBL study, MBL reduced drastically and 80% had amenorrhoea after 24 months. The ferritin values increased significantly. On a total of approximately 17,000 insertions, the perforation rate was between 1.2 and 2.0/1000 insertions.


CONCLUSIONS
The frameless FP-LNG-IUS is an effective and well-tolerated long-acting reversible contraceptive and is also highly effective for the treatment of HMB. The perforation rate is similar to traditional copper and levonorgestrel-releasing intrauterine devices and systems. Strict adherence to the manufacturer's insertion instructions is recommended.
Wildemeersch
Dirk
D
Outpatient Gynaecological Clinic and IUD Training Center, Ghent, Belgium. d.wildemeersch@skynet.be
Andrade
A
A
D000293:Adolescent; D000328:Adult; D003267:Contraception; D003271:Contraceptive Agents, Female / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007433:Intrauterine Device Expulsion; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects; D016912:Levonorgestrel / Q000008:administration & dosage; D008595:Menorrhagia / Q000628:therapy*; D008599:Menstruation Disturbances; D008875:Middle Aged; D011247:Pregnancy; D014595:Uterine Perforation / Q000453:epidemiology / Q000209:etiology
D003271:Contraceptive Agents, Female; D016912:Levonorgestrel