Medicine is a vast, fast moving field. No shame in a doctor not knowing everything about everything. But if you want the best possible advice re: birth contro

Medicine is a vast, fast moving field. No shame in a doctor not knowing everything about everything. But if you want the best possible advice re: birth control I'd suggest finding a better doctor. :) For your reference: The issue with IUDs and fertility is PID (Pelvic Inflamatory Disase). It was previously thought that having an IUD increased your risk of PID, but the latest research shows that the risk of PID is not associated with IUD use, but with IUD insertion. If you do not have an STI at the time of insertion, you're safe. Some research has even shown that the Mirena will lower the long term risk of PID, and a large study from China just came out showing that long-term use of IUD does not impact fertility. You seem primarily concerned not with PID, but the risk of perforation during insertion in roughly 1 in every 2,000 women. Which, first off, is a pretty damn low rate, and compares favourably to the risks of other birth control options. And second, while a perforation can be serious, even if not caught it should just heal on its own. Worst case, it might require surgery, but it's not going to cause long term fertility issues. Everyone has the right to choose which risks they're willing to take, to be sure. But I think you may be grossly misinformed if you think that the Mirena and similar IUDs convey significant risks of infertility. Don't get one inserted without an STI test, and get a followup check to make sure there's no perforation, and then there is no (repeat no) evidence of an increased rate of infertility.