Can a woman with a bicornuate uterus use an intrauterine device (IUD)?

Women with a bicornuate uterus are not suitable candidates for intrauterine device (IUD) insertion. Generally, women with a didelphic uterus—characterized by two separate uterine cavities—cannot use IUDs for contraception. IUD insertion also has several contraindications, including: acute genital tract inflammation; fever (temperature ≥37.5°C on two consecutive measurements); menstrual irregularities—such as variable cycle length, prolonged menstruation, or prolonged/irregular vaginal bleeding; and congenital uterine anomalies—including didelphic uterus, bicornuate uterus, unicornuate (rudimentary) uterus, or abnormally large or small uterine cavities. Alternative contraceptive methods include intrauterine devices (if anatomically appropriate), topical contraceptives, female tubal ligation, and male vasectomy.