In unadjusted analyses, rates of pregnancy within 1 year were similar among the groups
Levonorgestrel IUD: 2.40%
Copper IUD: 2.99%
Tubal ligation: 2.64%
In adjusted analyses, compared to tubal ligation, pregnancy was less common following placement of
Adjusted incident rate ratio (aIRR) 0.72 (95% CI, 0.64 to 0.82)
aIRR 0.92 (95% CI, 0.82 to 1.05)
Procedural complications such as infection were significantly less common with IUD placement than tubal ligation
IUD placement: 0.35%
Tubal ligation: 2.91%
Claims for pelvic and abdominal pain decreased in frequency over time regardless of contraceptive approach
At 6 to 12 months post-procedure, pelvic pain claims were less common after
Levonorgestrel IUD placement
aIRR 0.69 (95% CI, 0.65 to 0.73)
Copper IUD placement
aIRR 0.70 (95% CI, 0.66 to 0.75)
Results unchanged even after excluding patients at highest risk for post-procedure complications
Among patients with medicaid insurance, placement of a levonorgestrel or copper IUD is at least as effective at preventing pregnancy as tubal ligation 1-year post-procedure
Compared to tubal ligation, pregnancy within 1 year was
Lower than laparoscopic tubal ligation
Similar for copper IUD
Pain and infection were less common in patients who received an IUD vs tubal ligation
The authors state
As desire for reversal of tubal ligation is known to occur, it is important that all patients considering tubal ligation receive thorough counseling regarding the comparative safety and effectiveness of IUC prior to undergoing tubal ligation
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