"My IUD is expiring": A national U.S. mystery client study regarding use of the LNG 52-mg IUD for pregnancy prevention beyond 5 years after multiple FDA extensions.

Objectives: Since 2020, the Food and Drug Administration has approved multiple extensions to the use of the levonorgestrel (LNG) 52-mg intrauterine device (IUD) for pregnancy prevention beyond 5 years. The accessibility of this information to patients calling a reproductive health clinic to schedule replacement remains unknown. We assess the patient experience in accessing information via phone call on the duration of pregnancy prevention for LNG 52-mg IUD.

Study Design: We utilized a mystery client study design to inquire about LNG 52-mg IUD use beyond 5 years. Purposeful sampling ensured clinic diversity.

Results: In June 2022, 18 (32%) clinics offered extended use beyond 5 years, 25 (44%) recommended replacement at 5 years, and 14 (25%) could not provide information. The number of clinics offering extended LNG 52-mg IUD use did not significantly increase in August 2023 (n = 22, 39%, p = 0.27).

Conclusions: Patients scheduling a replacement of the LNG 52-mg IUD may not receive information about use beyond 5 years.

Implications: Reproductive health clinics scheduling staff need further training on updated guidelines.