IUD (Intrauterine device) Removal – Technique and Overview

Name of Procedure

IUD (Intrauterine Device) Removal

For replacement, see the IUD insertion article

Sample Opnote


Removal of an intrauterine device 


  • Desired pregnancy
  • Side effects from the IUD
  • IUD has reached the approved amount of time for effective contraception
    • Non-hormonal IUD: Paragard: Copper IUD; 10 years
    • Hormonal (levonorgesterol) IUDs: Mirena: 7 years; Liletta: 6 years; Kyleena: 5 years; Skyla: 3 years


No absolute contraindication


See below for landmarks and patient positioning



  1. Gloves
  2. Speculum
  3. Large cotton Q-tips, long or large cotton swabs
  4. Sterile Ring Forceps


  1. Gloves
  2. Speculum
  3. Tenaculum
  4. Ring forceps
  5. Cytobrush 
  6. Alligator forceps or IUD hook 

Landmarks and Patient Positioning

Dorsal lithotomy


  1. Simple IUD removal when strings are visible:
    1. Wear gloves, and insert the speculum and locate the cervix
    2. Locate the IUD strings at the cervical os
    3. Use ring forceps to grasp the string and remove the IUD by placing gentle traction on the strings and pulling it out
    4. Ensure the IUD is intact and no portions are missing
  2. If strings are not visible:  
    1. Use a cytobrush in the cervical os to try to tug the strings out, then follow the steps above to remove the IUD.
    2. If unable to fish the strings with a cytobrush then the patient may need alligator forceps or even a laparoscopic procedure under anesthesia. These procedures are beyond the scope of this article and evaluation by a gynecologist may be the next step.

Tools needed for IUD removal when strings are not visualized


  1. If the strings are not visualized on a pelvic speculum exam, consider pelvic US to determine the IUD location and refer to gynecologist


  1. Complicated IUD Removal | ACOG
  2. Mirena® IUD Insertion & Removal | HCP