The document describes the evolution of intrauterine contraceptive devices (IUDs) and the Mirena IUD inserter specifically. It discusses four generations of IUDs, with Mirena as the fourth generation. The newer Mirena EvoInserter is then presented, which features design changes like preloading the IUD horizontally, thinner removal threads, and a simplified one-step loading technique using the slider. Key differences between the old and new inserters are highlighted. The conclusion emphasizes the importance of proper insertion by an experienced doctor to minimize risks like expulsion or misplacement of the IUD.

3. Contraceptive museum

4. Dr. Lippe
in Yr.2000
at world
congress

5. First generatin
I.U.C.D.is
Lipes loop
Second generation
I.U..C.D.is
Copper T-200
Third generation
I.U.C.D.is
Gyne-T 380
With 4 years
Intra uterine life

6. .
4th generation IUCD

7. Mirena IUCD
Menorrhgia
Contraception
HRT
Endometriosis
Reproductive benefits

10. Mirena® old inserter
Open the sterile package
completely.
Release the threads.
Rotate the inserter so that the
centimeter scale is upwards (Fig.
1a).
Check that the arms of the system
are in horizontal position (Fig. 1b).
Holding the slider in the furthest
position, pull on the threads to draw
the IUS system into the insertion
tube (Fig. 2a).
If the knobs at the ends of the arms
do not meet properly (Fig. 2b),
release the arms by pulling the
slider back to the mark.
Re-load the product by aligning the
open arms on a sterile surface
(Figure 1a). Return the slider to its
furthermost position and pull on
both threads. Check for proper
loading (Fig. 2b).
Fix the threads in the cleft at the
near end of the inserter shaft (Fig.
Figure 1a Figure 1b
Figure 2a Figure 2b
Knobs at the
end of the
arms
Figure 2b

11. Why changes????

12. Packaging
Size of secondary package smaller
EvoInserter™ is positioned horizontally
in the primary package
Primary package contains a sticker

13. EVO Inserter
Threads are released when the
slider is pulled downwards and
past the mark
The IUS system is already in the
horizontal position in the package.
No need to check the horizontality.
New shape
of the slider
Scale on both sides
of the insertion tube
Loading of the IUS system is
achieved by only pushing
the slider upwards.
The removal threads are thinner and softer, and
are inside the inserter handle: no handling of
threads required for the loading of the IUS system.

14. Insertion procedure
Less preparatory steps:
simplified loading by pushing the slider forward to its
furthest position
Insertion technique remains the same as before!

15. Mirena® EvoInserter
Open the sterile package completely (Figure 1).
Push the slider forward in the direction of the
arrow to the furthest position to load Mirena®
into the insertion tube (Figure 2).
Figure 1 Figure 2

16. (Click the picture to see video)
Preparatory steps
Loading of Mirena®: note the arrow in the slider which
indicates the direction of movement

17. What has changed?
Dimensions
Mirena®
old inserter
Mirena®
EvoInserter™
Insertion tube cross-
section (mm)
4.8 4.4
Removal thread lenght
(cm)
40 27
Removal thread
thickness (mm)
0.30 0.27

18. Modified knobs to form a smooth sphere when loaded
NewOld
T-body of Mirena®

22. What is different about
this inserter?
threads are now inside the inserter handle, eliminating the
handling of threads
preloaded in the horizontal position
The arms of the LNG-IUS can be loaded into the inserter using a one-step
technique (slider pushed forward)
The diameter of the insertion tube, reduced from 4.8mm to
4.4mm
There is now a centimetre scale on both sides of the insertion tube
The LNG-IUS cannot be reloaded into the inserter if it is released
prematurely (important to avoid pulling the slider down before the inserter
is correctly positioned in the uterus)

23. To make it easy to insert in the correct position

25. GOLDEN RULE
IF YOU USE EXCESSIVE FORCE TO DO
ANYTHING, YOU ARE DOING SOMETHING
WRONG

26. CONCLUSION
Mirena I.U.C.D., if properly inserted with aseptic
precautions, by an experienced gynecologist,
chances of its expulsion, failure and misplacement
are rare and few.
Some patients experience pain during insertion as
the device is relatively bulky
Doctors must follow the instructions of application

27. THANK
YOU