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Intrauterine contraceptives (IUCs) are among the most effective contraceptives available, making them an attractive option for women such as transplant recipients, who face excess risk for pregnancy complications. Theoretical concerns are that immunosuppressive agents may diminish the effectiveness of intrauterine contraception and that pelvic infections may be more common among immunocompromised women who use IUCs.
In a recent case series, 6 adolescents used a levonorgestrel IUC after receiving a solid-organ transplant; none became pregnant and none developed pelvic inflammatory disease while receiving a variety of immunosuppressive medications.