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With the end to health insurance payments for birth control pills looming as a possibility in the near future, millions of American women are considering an IUD as a birth control option. Is an intrauterine device the best option?

President Trump has promised to repeal Obamacare. One of the provisions of the Affordable Care Act has been that every insurance company will provide every woman it insures with at least one brand of every FDA-approved form of contraception without need to pay a copay. If the Affordable Care Act is repealed, insurance coverage for contraception is likely to be repealed, too. Many women are looking for methods of long-term birth control such as an IUD. IUD is not a permanent birth control option, like tubal ligation - IUD is Removable and a woman can get pregnant again.  

What Is an IUD?

An IUD, or intrauterine device, is a small, usually T-shaped metal contraceptive that is placed in a woman's uterus to prevent conception. The device does not cause an abortion or interfere with the implantation of an egg that has already been fertilized. It only prevents sperm from reaching the egg, and an IUD is extremely effective at it. 

The IUD is inserted by a physician in a doctor's office. The two top bars of the T fit near the openings of the fallopian tubes, where the egg would be fertilized, and the longer section of the IUD rests perpendicular to the ovaries in the middle of the uterus. The IUD has a metal "string" attached so it can be removed if the woman using it desires to become pregnant. A woman can have a new IUD inserted the same day she has an old IUD removed.

How to IUD's Work?

An intrauterine device may be bare copper or copper coated with a slow-release contraceptive. Copper is toxic to sperm. Contact with the IUD immobilizes sperm so that it cannot reach the egg.

Hormonal IUD's (known as "intrauterine systems" in the UK), sold under brand names Liletta, Mirena, and Skyla in the English-speaking world, are coated with a hormone such as levonorgestril (progestin). The hormone is also a constituent of many brands of birth control pills, but the amount of the hormone that gets into the rest of the user's body is much lower. Progestin thickens the mucus of the cervix so sperm cannot swim toward the fallopian tubes. It also thickens the lining of the uterus so that should an egg be fertilized by a sperm, it is much less likely to be able to implant itself in the uterine lining.

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