I wanted to have an introductory video on IUDs that would go over the basics.

Because there are so many different types of IUD, each with its’ own inserter characteristics and clinical behavior, I had to limit myself to very general information.

Still, I thought this would be valuable for students. I wasn’t trying to qualify them for IUD insertion, just give them a general idea of what was involved.

Video is ideal for this purpose because it clearly shows the flexibility of the IUD.

I started off with a clear plastic model of relatively low fidelity. It seemed important to demonstrate how the arms open up inside the uterus, since that is one part that can’t be visualized in a real patient.

Then, I moved on to a live patient, using a mixture of photographs and video.

While demonstrating the bimanual exam, I inserted some ultrasound video to illustrate the internal aspects of the exam. This was an abdominal scan of a patient with an ovarian cyst. Because I could angle the transducer to place the cyst directly behind the uterus, it enhanced the image of the uterus, making the finger movements and uterine response more easily understood by the students. I wanted to demonstate how the vaginal fingers can elevate the uterus to the abdominal wall for palpation by the abdominal hand.

I selected a Copper T380 for the video. I had to choose something, and at the time, it was the most widely used IUD.

I know some people find the background music distracting, but my idea was that it was pleasant and relatively bland. It would fill the background when I wasn’t speaking, and then quiet down during speech. I believed that fewer words would have greater educational impact, and I wanted to avoid long audio silences in the video.

I made a lot of videos this way. I think if I were to redo it today, I’d probably get rid of the background music and just add more audio content. Less artistic, but likely more educational.

In this video, I focused strictly on the insertion and removal techniques. I omitted any discussion of why an IUD might be a good idea or a bad idea, or any of the other background information. It’s not that those other issues are unimportant…its’ just that I wanted to limit myself to 5 minutes.

The probe insertion clip demonstrates the difficulty of getting the lighting just right. This light is too bright and too much off to the side. Modern video cameras have so much sensitivity to light that you need to be very careful not to oversaturate.

It’s not necessary to always use ultrasound following an IUD insertion, but having one in my office next to the exam table, I’ve found it very useful.

I also wanted to demonstrate how simple it usually is to remove an IUD.

As with demonstrating the IUD insertion, I thought it a good idea to move back and forth between real patient video and see-through plastic models to convey what is going on inside the patient.