I personally loooooved my Paragard copper IUD. I got it in 2008, planned to have it out in 2018, and rejoiced when I learned that they upgraded the expiration date to 12 years, so I kept it in till this past May to TTC. The first couple years, I had heavier periods and more cramping, but that eased off the longer it was in there. It was great not to have to worry about barriers unless I was on my poly adventures. It was great to learn what my body felt like without the hormones messing with my sex drive, mood, and the feeling of natural ovulation. I really got to know my body so much better—I’d been on the pill from 1996–2008, so that was a long run.
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I thought the copper IUD principle of operation was partly that it did cause local hormonal changes…?
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I don’t think so. It changes the lining of the uterus so that it’s not hospitable.
From my perspective, the problem is that it’s not as effective as the hormonal IUD, and if it fails, miscarriage (or ectopic pregnancy) is a super likely outcome. That was really traumatic for me personally, but for a person who feels pretty sure that they would terminate a method failure pregnancy, it might not be an issue.
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I think you’re thinking of the Mirena, which lets off very low amounts of hormones that are supposed to affect only the local area.
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This post got me looking into bc failure rates again, which I hadn’t done in a really long time, and looking really for the first time at cumulative failure rates vs. the failure rate they usually list which is yearly.
I was always impressed at Paragard’s less-than-1% failure rate—which was on par with the pill from the last info I’d looked at (both used to be listed everywhere as being 99% effective). I now see that Paragard’s yearly failure rate is still listed at 0.8%, while the pill is 9% (!!), so I guess they stopped using the “perfect use” standard and moved to “typical use.” And Mirena is 0.2%.
Cumulative failure rate for IUDs was a little harder to track down, but I found that Mirena has a 5-year cumulative failure rate of only 0.7%, and Paragard’s 10-year is 2.1–2.8%.
So it seems that, if effectiveness is one’s only concern, then Mirena wins out over Paragard by being approximately 4x more effective both yearly and over the life of the method.
For me, personally, the longer effectiveness of Paragard (because the pain of getting it placed was a bitch and also I am lazy) + the lack of hormones (because I’d already been on them so long and wanted to get to know my body without them) made that the better choice.
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My only Qs on this would be:
-does past failure on an IUD predict future failure? It seems to
-anatomical and weight considerations, (weight being relevant for hormonal methods) and their role
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Yeah, that would be interesting to learn. They should put out a chart like the CDC chart I linked but with added asterisks to caveats that may have been found such as those. I didn’t see it in my cursory searching since I wasn’t using those keywords (and don’t have time to look into it right now) but it’d be super interesting to know.
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Partially it’s because we don’t have the research yet, I think. I routinely get recruitment emails and targeted FB from OHSU because they’re studying BC failure in higher body weight women. So I think it’s very much an active area of research. ESP with low dose hormonal methods, since those are pretty new relatively.
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I think I was remembering that it caused an inflammatory response but mis-characterizing it…
Well. The time has arrived. I’m back into the TTC fray. I oscillate between “does it even matter, it’ll take another 2 years if it ever happens” and “oh my god what if it happens” and like… just so many emotions. If we somehow succeed “naturally” soon, I’ll try my best to just be grateful and not fucking panic. 
and if I don’t succeed, I’m going to try my best not to spiral right back into the pit of infertility misery emotions. Wish me luck!
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Wishing you luck!
I haven’t had a period since going off BCP which is irritating. Because we were advised not to start until I do.
Gonna go see new obgyn under new insurance at 3mos if nothing happens. Or likely even if it does!
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Good luck!
We are indecisive. From day to day we go from “thank god we’re not trying until November, too much is happening right now” and “But what if we just… started now? We could have a baby by the end of the year maybe?”
It’s probably a good thing my BC has to be removed by a doctor.
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We are here for you during this rollercoaster ride.
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Once more unto the breach! Welcome back!
IIRC you have frozen embryos? So you might have to decide how long to wait for another spontaneous miracle before deciding to try a transfer instead?
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My periods didn’t regular for a full year after I went off HBC. I had I think four periods that whole time? They would give me progesterone pills* to bring on my period. I hope you have much better luck–my experience was super unusual and was not repeated when I went back on the pill for several months later–just sharing what they did for me!
*I just swallowed them. Fertility progesterone is often taken by… other routes… but that was not necessary for this purpose.
Good luck!
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We do indeed. 3 genetically normal, 1 low mosaic. Although since my last PGS normal transfer was a chemical, my RE told me that “he’s cautiously optimistic I could get one pregnancy from the 3”. 
very reassuring, lol. Although that was before the spontaneous pregnancy, so I have no idea what my “probability picture” looks like now. All are pretty high grade.
Anyway, it’s a very good question and one I don’t have a solid answer on. A while? Luckily uterine receptivity doesn’t change with age as much as oocyte quality stuff does, so my shit ovaries won’t play a role. And since I’ve carried to term once now, that gives me good uterine odds. I think we’d probably want to wait until post covid/post vaccine before moving to transfers, and let Latte get a little older first. 2.5-3 years would probably be my ideal spacing, and Latte is only 13.5 months now. Although SirB is 5 years older than his siblings, and all of my full siblings are within 2 years of the next, so we have a front row seat to very different spacings. 
Good and bads to them all.
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My RE advised NOT waiting for the vaccine for my next transfer, but our situations are super different–you have a history of spontaneous conception with your CURRENT partner and aren’t almost 40! So it makes sense that you would want to give it some time.
I’m sure your odds of a successful transfer are much higher now that you’ve conceived on your own and carried to term… at least based on how my RE talks to me as a person who has done so.
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Yeah I’m not waiting on TTC, even though I’m technically phase 1 (though like, class C? Or something under Oregon’s plan), since I’m not actually taking patients right now and I don’t feel like we have time to waste if I want a shot at another Free Sex Miracle Baby.
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Fingers crossed! Good luck!
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Fingers crossed for you. Here for you for all the feels on this ride.
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