Treatment: intrauterine device (IUD)

Laboratory tests

• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR) on vaginal sample, otherwise on first-catch urine (if STI risk factor or age ≤ 25 years)if neededTo request when the patient has an STI risk factor (partner of less than 3 months, multiple partners in the year, history of STI, unprotected intercourse) or is 25 years or under: the CNGOF does not recommend routine screening before insertion but recommends it in the presence of risk factors ^[2], and HAS recommends opportunistic Chlamydia screening in sexually active women aged 15 to 25 years, targeted beyond that in case of a risk factor ^[3]. Depending on practices and exposure, several sites may be sampled (throat, anus, vagina or urine): the NABM provides a code for 2 sites (5302) and one for 3 sites (5303), in place of the single sample (5301) ^[4].
• Several sites can be sampled depending on practices and exposure (throat, anus, vagina or urine): procedure codes 5302 (2 sites) and 5303 (3 sites).
• Mycoplasma genitalium NAAT (PCR) on vaginal sample (if symptomatic cervicitis before insertion)if neededTo request only if the patient has symptoms of cervicitis before insertion (mucopurulent cervicitis, intermenstrual or post-coital bleeding, dysuria with no other cause): this is the indication retained by the 2021 European guideline ^[5] and by HAS (2025), which advises against this test in an asymptomatic woman, notably as screening ^[6]. For the NABM, the combined test with Chlamydia and gonorrhoea (5304) is reserved for acute cervicitis and then replaces the Chlamydia/gonorrhoea PCR alone; the isolated test (5305) is limited to recurrent or persistent cervicitis ^[4].
• hCGif neededThe Mirena SmPC asks to exclude any possibility of pregnancy, in particular with a pregnancy test ^[7]; the CNGOF allows insertion at any point in the cycle provided there is certainty that there is no ongoing pregnancy ^[2].