FAQ Healthcare Professionals

Below you will find the most frequently asked questions by healthcare professionals and the answers to them. Is your question not here? Then please contact us.

FAQ Professionals

A copper IUD, such as the T-Safe (TCu380A), has been one of the most reliable and effective forms of contraception for years. Research attributes the contraceptive effect of a copper IUD to the copper's effect on the activity of sperm cells in the uterus. The copper ions paralyse the sperm cells, preventing them from fertilising the egg. In addition, the presence of the IUD prevents implantation from taking place. Scientific research has shown that the action of the copper-containing IUD is basically based on preventing fertilisation by inactivating the sperm cells in the uterus. A copper IUD is a contraceptive and not an abortifacient. No monthly fertilisation takes place in users of a copper IUD. Read more in this article.

If, on ultrasound, the coil is in the cavum uteri (regardless of its location in relation to the fundus), there is no reason for action or concern (NHG Standard Contraception, May 2020). Read more in this article. 

The NHG Standard Contraception (May 2020) recommends a follow-up check 6 weeks after placement. This should address satisfaction, complaints and side effects. Check in speculo for visible threads. In case of non-visible threads: perform a transvaginal ultrasound. In the absence of complaints and with an IUD in situ, further (self) checks are not necessary. Finally, advise to contact the doctor in case of side effects, complaints or questions.

The risk of a perforation is 1 in 1,000 placements. Women who are breastfeeding and/or <36 weeks postpartum have an increased risk of perforation, namely 6 in 1,000 women. If you wish to have an IUD during lactation, because of the increased risk of uterine perforation, weigh the advantages and disadvantages of earlier implantation against those of implantation after the cessation of breastfeeding. Perforation is often asymptomatic and is sometimes not noticed at the time of implantation. The most important indications for a perforation are: the absence of threads at the check-up after 6 weeks or complaints, such as persistent pain in the lower abdomen, fever and vaginal bleeding. A perforation can be diagnosed with a transvaginal ultrasound. If there is a perforation, referral to a gynaecologist is recommended.

The advice is not to use a menstrual cup in combination with an IUD. Research has shown that there is a greater risk of expulsion when using a menstrual cup. If the woman still wishes to use a menstrual cup, the advice is not to do so until three months after placement. Make sure that the vacuum is broken before removing the cup, without pulling the wires of the IUD. In addition, always check that the IUD is not in the cup. Read more about the risk of expulsion in this news release.


After probing, it sometimes happens that the ostium internum tightens due to the stimulation, making it impossible to insert the coil. A solution may be to wait a few minutes until the spasm has passed. A second option is to leave the probe in place while the IUD is being prepared. Then, after the probe is removed, the coil can be inserted in one movement without causing the cervix to contract. Finally, the use of a dilator can also offer a solution.

Strong anteflexion or retroflexion of the uterus sometimes prevents the probe or insertion sleeve from being inserted into the fundus. Sufficient traction with the ball forceps may help. In addition, it may be considered to have the woman come with a half-full bladder. In this way, the bladder presses the uterus more into an extended position, making passage of the curve easier.

When cutting the threads, use sharp scissors to prevent accidental pulling of the threads.

First remove the white pusher and then remove the applicator sleeve in a twisting motion. This will prevent the wires from getting stuck between the pusher and the ferrule.

Recommendation: When inserting the T-Safe, keep the white pusher connected to the coil. This provides extra strength to the applicator and prevents the applicator from buckling.

Yes, this is possible. It is, of course, very annoying if something goes wrong with the placement of an IUD. Unfortunately, expulsions shortly after the coil placement also occur. For this reason, Titus Health Care offers the replacement regulation. This means that women do not have to incur additional costs for a new coil. After a failed implantation or an expulsion within six months, a replacement coil can be requested free of charge via the digital replacement form. After receiving the form, we will send you a new coil within two weeks, free of charge. Unfortunately, there is no possibility of a refund.

Yes, this is possible. Madam then pays a lower rate. The DBC codes for placement excluding coil are:

  • DBC care product code: 210301015
  • DBC care activity: 037180

A clinically proven copper allergy is very rare. There is no scientific study that investigates a direct link between a copper allergy and a copper IUD. In addition, a copper IUD releases a very low amount of copper into the uterus. If a woman has a clinically proven copper allergy, which has been diagnosed by a dermatologist or other health professional, this is a contraindication for the use of a copper IUD.

Removal or replacement of a copper coil can be done at any time of the cycle. If pregnancy is not desired, a replacement coil should be placed afterwards or another method of contraception should be used. Ovulations often continue during copper and hormone IUD use. Theoretically, ovulation may have occurred shortly before the IUD was removed. Sperm cells can live up to about 5 days. If you have sex just before removal, sperm cells can still fertilise an egg. The risk of this is probably very small.

If unprotected sex has taken place in the week preceding the removal and in the event of unsuccessful replacement or failure to switch to another method: Discuss the, probably very small, risk of pregnancy through implantation of an already fertilised egg and consider the possibility of the morning-after pill.

The ZI number of T-Safe is 15539377.

There are several types of copper coils available. T-Safe is the most widely used copper coil in the Netherlands. T-Safe has high reliability, protects against pregnancy for 10 years and is of high quality. The overview below lists the most commonly used copper coils in the Netherlands and their main characteristics.

Product name T-Safe Multi-Safe Multi-Safe short Flexi-T 300 Flexi-T +300 Flexi-T +380
Copper surface 380 mm2 375 mm2 375 mm2 300 mm2 300 mm2 380 mm2
Dimensions 36 mm x 32 mm 35.2 mm x 19.5 mm 29.4 mm x 19.5 mm 29 mm x 23 mm 32 mm x 28 mm 32 mm x 28 mm
ZI number 15539377 16021517 16021509 14145456 14847353 14964716
Length of stay 10 years 5 years 5 years 5 years 5 years 5 years
Uterine length 6-9 cm 6-9 cm 5-8 cm 5-8 cm 6-9 cm 6-9 cm
Details - Preferred NHG
- Most widely used copper spiral in NL
- Preferred NHG
- One-hand push-in technique
- Preferred NHG
- One-hand push-in technique
One-hand push-in technique One-hand push-in technique One-hand push-in technique
Website t-safe.com multi-safe.co.uk multi-safe.co.uk flexi-t.co.uk flexi-t.co.uk flexi-t.co.uk