Follow-up visits after IUD insertion - Are more better?

OBJECTIVE: To determine whether frequent follow-up visits for intrauterine device (IUD) users prevents the development of pelvic inflammatory disease (PID). STUDY DESIGN: A prospective, cohort design was used to study 1,713 women wh o received an IUD in 1992 in Mexico. They were divided into two different f ollow-up regimens and were asked to return for either two or four revisits in the first year after insertion. The main outcome measures included incid ence of PID and asymptomatic/symptomatic lower genital tract infections. Ti me to detection of lower genital tract infections wits measured in a propor tional hazards regression model; this analysis achieved 90% power to detect differences between the regimens. RESULTS: The two regimens were nearly identical in terms of PID incidence. The incidence rates for asymptomatic and symptomatic lower genital tract in fection were slightly higher in the four-visit regimen; however, the incide nce rate ratios were not statistically elevated: 1.41 (0.77-2.56) and 1.23 (0.67-2.27), respectively. In the regression, the variable denoting follow- up regimen was not associated with time to detection of lower genital CONCLUSION: More follow-up visits for IUD users provide no benefit in terms of preventing PID or progression toward the disease.