Retracted: Effects of a levonorgestrel intrauterine system versus a copper intrauterine device on menstrual changes and uterine artery Doppler

Objective To compare the effects of a levonorgestrel‐releasing intrauterine system ( LNG ‐ IUS ) and a copper intrauterine device (Cu‐ IUD ) on menstrual changes and uterine artery Doppler indices. Methods A randomized clinical trial was conducted at Menoufia University Hospital, Egypt, between December 2016 and August 2017. 306 multiparous women desiring intrauterine contraception were randomly assigned to LNG ‐ IUS (n=152) or Cu‐ IUD (n=154). Uterine artery pulsatility index ( PI ) and resistant index ( RI ) were measured before use, and 3 and 6 months after insertion, and associations with abnormal bleeding were evaluated. Results Irregular bleeding was initially reported by 31 (74%) of 42 women in the LNG ‐ IUS group, and heavy menstrual bleeding by 53 (67%) of 79 women in the Cu‐ IUD group. Incidence of abnormal bleeding decreased over the 6‐month study period. Uterine artery PI was significantly correlated with abnormal bleeding at a cutoff of 1.35 with area under the curve ( AUC ) 0.93, sensitivity 88%, and specificity 100%, whereas uterine artery RI was significantly correlated with abnormal bleeding at a cutoff of 0.62 with AUC 0.1, sensitivity 96%, and specificity 100%. Conclusion LNG ‐ IUS ‐related abnormal bleeding was associated with changes in uterine artery blood flow that were not evident among Cu‐ IUD users. Pan African Clinical Trials Registry: PACTR 201701001900640.