Levonorgestrel IUD: is there a long-lasting effect on return to fertility?

  • Erin Dinehart
  • Ruth B. Lathi
  • Lusine AghajanovaEmail author


Intrauterine devices (IUDs) are effective and safe long-acting reversible contraceptive methods for preventing unplanned pregnancies. While extensive studies were conducted to evaluate return to fertility after removal of IUDs, majority of them were focused on multiparous women using copper IUDs. Current trends indicate increased use of levonorgestrel (LNG) IUDs in nulliparous women for very long periods of time, with both nulliparity and long duration of LNG-IUD use being potentially associated with trends towards longer time to conception post removal. Understanding the effects that LNG-IUDs may have on endometrial morphology and gene expression has important implications to further understanding their mechanism of action. Studies examining endometrial gene expression show persistent changes in receptivity markers up to 1 year after removal of an inert IUD, and no similar studies have been performed after removal of LNG-IUDs. Given the current gap in the literature and trends in LNG-IUD use in nulliparous young women, studies are needed that specifically look at the interaction of nulliparity, long-term use of LNG-IUD, and return to normal fertility. Herein, we review the available literature on the mechanism of action of IUDs with a specific focus on the effect on endometrial gene expression profile changes associated with IUDs.


Endometrial gene expression Infertility Intrauterine device Levonorgestrel LNG-IUD Copper IUD 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Erin Dinehart
    • 1
  • Ruth B. Lathi
    • 2
  • Lusine Aghajanova
    • 2
    Email author
  1. 1.Department of Obstetrics and GynecologyGeorge Washington UniversityWashingtonUSA
  2. 2.Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and GynecologyStanford UniversityStanfordUSA

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