Introduction: The levonorgestrel intrauterine contraceptive system (LNG-IUS) is safe and effective for contraception, dysmenorrhea, and treatment of heavy menstrual bleeding. Safety and efficacy has been established in patients with HIV, but there are limited data supporting its use in immunosuppressed women who have received organ transplants. The objective of this study was to determine rates of pregnancy, complications, and continuation among women with transplants using the LNG-IUS.
Methods: We completed a retrospective chart review of all transplant patients who had a LNG-IUS at our institution between January 2008 and March 2012. Data including patient characteristics, indications for placement of the LNG-IUS, and complications including perforation, unintended pregnancy, expulsion, and pelvic infection were collected.
Results: Sixteen solid organ transplant recipients had a LNG-IUS inserted during the study period (8 kidney, 1 kidney/pancreas, 4 cardiac, 2 lung, 1 liver). The indications for placement included contraception (75%), menstrual suppression (68.8%), heavy menstrual bleeding (43.8%), and dysmenorrhea (18.8%). The mean age at placement was 22.3 years (SD 6.5 years). 4 patients had the LNG-IUS in place at the time of transplant and 12 had it placed at a mean of 67 months post-transplant. There were no pregnancies or cases of pelvic inflammatory disease. The expulsion rate was 6.25% (1/16). One patient opted for removal due to irregular bleeding and cramping. Most patients (87.5%, 14/16) were continuing use of the LNG-IUS at their last follow up appointment with a 24-month mean (SD 15.9 months) duration of use. There were 8 episodes of rejection pre-IUS and 6 episodes post-IUS placement. The post-IUS rejection episodes occurred at a mean of 20.2 months post-IUS (SD 11.3 months).
Conclusions: The LNG-IUS is associated with high continuation and low complication rates in this cohort of young female organ transplant recipients. These data provide evidence that the LNG-IUS is a safe and effective contraceptive option for female organ transplant recipients.
To cite this abstract in AMA style:Nizamic T, Oelschlager AAmies, Debiec K, Smith J, Micks E, Prager S. Safety and Efficacy of the Levonorgestrel-Releasing Intrauterine System in Transplant Patients [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/safety-and-efficacy-of-the-levonorgestrel-releasing-intrauterine-system-in-transplant-patients/. Accessed November 24, 2020.
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