Clinical efficacy and safety of indomethacin-gyneFix IUD combined with a levonorgestrel-releasing intrauterine system in patients with adenomyosis and different uterine cavity depths.

TL;DR

A combination of indomethacin-GyneFix IUD plus levonorgestrel-releasing intrauterine system (LNG-IUS) reduced device displacement/expulsion rates (2.22% vs 10.00-18.89% for comparators) at 6 months in adenomyosis patients, with particular benefit in those with deeper uterine cavities (>9 cm).

Key findings

• GyneFix IUD + LNG-IUS demonstrated significantly lower displacement/expulsion rates (2.22%) compared to ring IUD + LNG-IUS (10.00%) and LNG-IUS alone (18.89%) at 6 months
• All three groups showed comparable symptom improvement in dysmenorrhea, menstrual blood loss, hemoglobin levels, and serum CA125 markers
• Device stability advantage was most pronounced in patients with uterine cavity depth >9 cm, suggesting depth-related selection benefit
• Patient satisfaction and willingness to recommend were highest in the GyneFix IUD + LNG-IUS group (95.12% and 90.24%, respectively)

Why this matters at the bedside

This finding addresses a significant clinical limitation of LNG-IUS therapy in adenomyosis—device displacement and expulsion—particularly relevant for patients with enlarged uteri or deep uterine cavities who would otherwise be at higher risk of treatment failure with conventional IUD designs.