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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Advances in Intrauterine Contraception and Therapeutic Intrauterine Devices, 2016–2026: A Targeted Scoping Review

  • Marius Biriș1,2
  • Victor Bogdan Buciu3,4
  • Ioana Mihaela Cîtu5
  • Andrei Pescaru3,6
  • Răzvan Roșca7
  • Raluca Pârvănescu2,3
  • Larisa Tomescu1,2
  • Denis Mihai Serban1,2
7 affiliations
  1. 1Department of Obstetrics and Gynecology, “Victor Babeș” University of Medicine and Pharmacy, 300074 Timișoara, Romania
  2. 2Obstetrics-Gynecology Clinic IV, Timișoara Municipal Emergency Clinical Hospital, 300074 Timișoara, Romania
  3. 3Doctoral School, “Victor Babeș” University of Medicine and Pharmacy, 300074 Timișoara, Romania
  4. 4Discipline of Methodology of Scientific Research, Department III—Functional Sciences, “Victor Babeș” University of Medicine and Pharmacy, 300074 Timișoara, Romania
  5. 5Department of Internal Medicine I, “Victor Babeș” University of Medicine and Pharmacy, 300074 Timișoara, Romania
  6. 6Obstetrics and Gynecology Clinic II, Timișoara Emergency Municipal Clinical Hospital, 300074 Timișoara, Romania
  7. 7Department III—Functional Sciences, Discipline of Medical Informatics and Biostatistics, “Victor Babeș” University of Medicine and Pharmacy, 300074 Timișoara, Romania
Open at sourceDOICite

Abstract

Intrauterine contraception has changed over the past decade through longer validated duration, lower-dose hormonal devices, redesigned copper devices, new indications, and better safety surveillance. This targeted scoping review (OSF registration 10.17605/OSF.IO/3GUQF) mapped English-language primary human studies published from 1 January 2016 to 5 September 2026 in journals indexed in the Science Citation Index Expanded (SCIE). A reproducible search targeted to the major device programs, randomized trials, and large surveillance cohorts identified 766 PubMed/MEDLINE records, with no additional unique records from Scopus or Web of Science; of the 624 unique records screened, 123 reports were assessed, and 114, from 66 distinct trials, cohorts, or data sources, were included and appraised with design-specific Joanna Briggs Institute (JBI) tools. Two single-arm programs and a 7-year randomized trial supported the efficacy of 52 mg levonorgestrel intrauterine devices (LNG-IUDs) through 8 years. Lower-dose LNG-IUDs eased placement but were associated with higher ectopic pregnancy rates in four Scandinavian analyses and with less antidepressant use than the 52 mg device. Smaller or size-matched copper devices improved continuation and reduced expulsion in randomized comparisons, whereas a low-copper nitinol device had a higher 5-year pregnancy rate than expected with TCu380A. Perforation was uncommon but more frequent after postpartum insertion and during breastfeeding; immediate postpartum insertion carried the highest expulsion risk. One randomized trial and its secondary analyses supported the 52 mg LNG-IUD for emergency contraception. Therapeutic evidence was strongest for heavy menstrual bleeding and endometrial hyperplasia, whereas intrauterine ball and precious metal designs showed no consistent benefit. Progress refined rather than replaced the T-shaped IUD.

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Cite

BibTeXRIS
BibTeX
@article{biriș2026advances,
  title = {{Advances in Intrauterine Contraception and Therapeutic Intrauterine Devices, 2016–2026: A Targeted Scoping Review}},
  author = {Marius Biriș and Victor Bogdan Buciu and Ioana Mihaela Cîtu and Andrei Pescaru and Răzvan Roșca and Raluca Pârvănescu and Larisa Tomescu and Denis Mihai Serban},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218338},
  url = {https://www.mdpi.com/2077-0383/15/21/8338},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Advances in Intrauterine Contraception and Therapeutic Intrauterine Devices, 2016–2026: A Targeted Scoping Review
AU  - Marius Biriș
AU  - Victor Bogdan Buciu
AU  - Ioana Mihaela Cîtu
AU  - Andrei Pescaru
AU  - Răzvan Roșca
AU  - Raluca Pârvănescu
AU  - Larisa Tomescu
AU  - Denis Mihai Serban
PY  - 2026
DA  - 2026/10/26
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218338
UR  - https://www.mdpi.com/2077-0383/15/21/8338
AB  - Intrauterine contraception has changed over the past decade through longer validated duration, lower-dose hormonal devices, redesigned copper devices, new indications, and better safety surveillance. This targeted scoping review (OSF registration 10.17605/OSF.IO/3GUQF) mapped English-language primary human studies published from 1 January 2016 to 5 September 2026 in journals indexed in the Science Citation Index Expanded (SCIE). A reproducible search targeted to the major device programs, randomized trials, and large surveillance cohorts identified 766 PubMed/MEDLINE records, with no additional unique records from Scopus or Web of Science; of the 624 unique records screened, 123 reports were assessed, and 114, from 66 distinct trials, cohorts, or data sources, were included and appraised with design-specific Joanna Briggs Institute (JBI) tools. Two single-arm programs and a 7-year randomized trial supported the efficacy of 52 mg levonorgestrel intrauterine devices (LNG-IUDs) through 8 years. Lower-dose LNG-IUDs eased placement but were associated with higher ectopic pregnancy rates in four Scandinavian analyses and with less antidepressant use than the 52 mg device. Smaller or size-matched copper devices improved continuation and reduced expulsion in randomized comparisons, whereas a low-copper nitinol device had a higher 5-year pregnancy rate than expected with TCu380A. Perforation was uncommon but more frequent after postpartum insertion and during breastfeeding; immediate postpartum insertion carried the highest expulsion risk. One randomized trial and its secondary analyses supported the 52 mg LNG-IUD for emergency contraception. Therapeutic evidence was strongest for heavy menstrual bleeding and endometrial hyperplasia, whereas intrauterine ball and precious metal designs showed no consistent benefit. Progress refined rather than replaced the T-shaped IUD.
SN  - 2077-0383
ER  -