This study is a randomized controlled trial of insertion of the levonorgestrel-releasing
intrauterine device (LNG-IUD) immediately following dilation & evacuation (D&E) compared to
delayed insertion 3-6 weeks post-D&E. Eighty-eight women undergoing D&E between 15 0/7 and 23
6/7 weeks gestation will be enrolled at Magee-Womens Hospital, Pittsburgh, PA. The primary
outcome is LNG-IUD usage six months following enrollment. We hypothesize that more women
receiving immediate insertion will be using the LNG-IUD 6 months after the D&E procedure than
women receiving delayed insertion. Secondary outcomes include the proportion receiving an
IUD, continuation rate, complication rates, subject satisfaction, and quality of life. The
utility of ultrasonography in predicting expulsion will also be examined. Anticipated
problems include poor subject follow-up and coordinating the intra-operative study
procedures.