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Abstract Intrauterine device (IUD) are safe, reliable and highly effective forms of long-acting reversible contraception. (1) The major advantage of LARC compared with other reversible contraceptive methods is that they do not require ongoing effort on the part of the patient for long-term and effective use. In addition, after the device is removed, the return of fertility is rapid (2) Studies of IUD use implemented and monitored by Family Health International in 80 centers located in 33 countries found the incidence of IUD insertion failures to be between 2.3 and 8.3 per 1000 insertions. (3) According to the latest practice recommendations for contraceptive use by the Centers for Disease Control and Prevention, the potential barriers to IUD use include anticipated insertion pain and health care providers‘ concerns about difficult insertion (4). It is therefore important to identify effective approaches to ease IUD insertion in order to overcome obstacles hindering IUD use. (5) Cervical ripening is made possible by the use of medication through different routes (6-8) the most commonly used agent is misoprostol, a synthetic prostaglandin E1 (PGE1) analogue that is frequently administered in off-label use in obstetrics and gynecology for medical abortion, labor induction, endometrial biopsy, dilatation and curettage, intrauterine device insertion, myomectomy, postpartum hemorrhage, and cervical ripening. |