Gynecology And Obstetrics-

GyneFix® copper chain

What is a GyneFix®?

A Gynefix® is a hormone-free method of contraception.

This is a small copper chain that is inserted directly into the woman's uterus. The operating principle corresponds to that of an intrauterine device (also called a spiral): the Gynefix® consists of copper, which in turn inhibits the movement of the sperm.
This allows the sperm to enter the uterus after the sexual act, but not the fallopian tubes and fertilization of the mature egg is prevented. In addition, the copper chain causes a slight inflammation of the uterine lining, which prevents the implantation of a possibly fertilized egg. The Gynefix® can be used for contraception by women of all ages and is particularly suitable for women who do not want to use hormonal contraception.

Are you interested in other hormone-free contraception methods? Find out more about the topic on our overview page:

Hormone-free contraception

How safe does the GyneFix® work?

Gynefix® has a high level of security in terms of contraception.

Intrauterine pessaries, including the Gynefix®, are generally among the safest contraceptives currently available on the market.
The effectiveness of a contraceptive method is indicated using the Pearl Index: the lower the value, the safer the method. The Gynefix® has a pearl index of 0.1-0.5.
In comparison, condoms have a Pearl Index of 2-12.

The manufacturer states that the contraceptive safety is 99.9%. The main advantage of a copper chain is that women no longer have to worry about contraception for several years after implanting the Gynefix®.

Find out more about contraception: Mechanical contraceptives

What does the GyneFix® cost?

The Gynefix® can be bought in the pharmacy and costs around 130 €.
In addition, there are costs for the implantation at the gynecologist. This varies from doctor to doctor, but you should expect around € 200-300.

Overall, the costs are around € 350-450. The Gynefix® usually remains in the uterus for five years.
Seen over the year, a copper chain costs between 70-90 €.

Also compare this to the cost of the IUD: What does the IUD cost?

When does the health insurance company cover the costs?

Most service providers only assume the costs of the copper chain in exceptional cases.
For example, some health insurances cover the cost of contraceptives and thus also of a Gynefix® for young women up to the age of 20.
For women who cannot use other contraceptives due to hormone intolerance, health insurance companies offer partial coverage of the costs.

Which doctor uses the copper chain?

A copper chain is implanted by the gynecologist.
Since the GyneFix® is a special model of a copper chain, it can only be used by specially trained gynecologists. There is a list of doctors on the Internet who are qualified to use a GyneFix®.

As part of a preliminary talk, the doctor explains the various options for contraception to the patient. After all questions have been answered and the advantages and disadvantages of a Gynefix have been explained, the operation can be carried out directly in the practice.
The check-up every six months, during which the correct position of the Gynefix is checked, can be carried out by any gynecologist and does not require a specially trained doctor.

Which side effects can occur?

A GyneFix® can cause various side effects.
The most common complaints after implantation include:

cramping pain,
occasional spotting and
heavier and / or longer menstrual periods.

In rarer cases it can happen that the anchorage of the copper chain loosens and the chain is ejected.

The implantation of the GyneFix® in the uterus is an invasive procedure that involves certain risks, even if the likelihood of this is very low. When the Gynefix is anchored in the uterus, for example, a perforation, i.e. a piercing of the uterine wall, can occur. There is also a certain risk that the copper chain could become infected and cause inflammation after implantation. At 0.54%, this risk is very low.

Most women, however, tolerate a GyneFix® very well and no longer have any symptoms after the initial implantation pain.

Spotting

In the first few days after implantation of a GyneFix®, most women experience light spotting.
This is normal and nothing to worry about.

In order not to aggravate the bleeding, one should avoid hot baths or hot water bottles in the first few days after the implantation, as these measures further promote the blood flow to the uterus.
In addition, women are not allowed to have sexual intercourse or insert tampons into the vagina for the first week.
The spotting usually subsides and disappears after a few days.

inflammation

Implanting a copper chain carries the risk of certain complications. These include inflammation of the uterus or fallopian tubes.
By introducing instruments and foreign objects into the uterus, bacteria can enter the body and lead to infection.

Abdominal infections cause severe abdominal pain, fever and purulent discharge in the affected women. In addition, sexual intercourse is perceived as painful and extremely uncomfortable. If an inflammation is suspected, the affected women should contact their doctor immediately.
The infection can usually be treated very quickly and easily with antibiotics.

How is the copper chain implanted?

In an informative talk at the beginning of the treatment, the patient is informed about the implantation process and possible risks.
Then she has to sign a declaration of consent. A prerequisite for the implantation of a copper chain is also an inconspicuous cancer smear, which must not be older than one year.

Before the procedure, the gynecologist will examine the uterus and assess whether the GyneFix® can be used.
The time of implantation depends on the cycle, as the uterine wall must have a certain thickness in order to anchor the chain. If the wall thickness is too small, there is a risk of being punctured (perforation). The best time is at the end of the second half of the cycle.

To insert the GyneFix®, the vagina is disinfected and an application instrument is inserted into the uterus. This instrument is used to insert the copper chain into the uterus. With the help of a small needle, the chain is pushed about an inch into the wall of the uterus. A GyneFix® consists of several small copper rings that are threaded onto a surgical thread and anchored over this at the upper end of the uterus.
The copper chain is attached in such a way that only one end of the thread is implanted into the uterus, while the other end remains loose. The muscle grows together around the knot and anchors the GyneFix® in the tissue. There is a small piece of metal on the anchoring knot that is visible on ultrasound. This allows the correct position of the GyneFix within the uterus to be assessed immediately after the implantation.
The procedure is quick and the entire duration of the treatment, including the preliminary discussion, is around an hour.

Pain on insertion

One end of the copper chain is anchored in the uterus with a knot. Since this process involves a puncture of the uterine muscle, there is often pain when the GyneFix® is inserted. In order to keep the pain as low as possible, the gynecologist performs a local anesthetic before the procedure. For this, a local anesthetic is injected into the area of the inner and outer cervix.
A short general anesthetic is only used for particularly anxious women or women with an increased sensitivity to pain. In most cases, a short anesthetic is not necessary.

Some women report a brief, stabbing pain when the GyneFix® is anchored.
Whether and how severe this pain occurs is difficult to say in advance, as every woman reacts differently to the implantation.
The severity of the pain can also be related to when it started.
Implantation is likely to be associated with less pain during menstruation.

Very severe pain when inserting the copper chain can be an indication of a perforation. The wall of the uterus is pierced and a hole is formed that opens into the abdominal cavity. If the perforation is recognized and treated immediately during the procedure, the wound will usually heal without complications.
If the perforation is noticed later, the patients suffer from severe pelvic pain and increased bleeding. Since a GyneFix® may only be used by specially trained gynecologists, the risk of perforation during implantation is very low.

Can a GyneFix cause pain?

Abdominal pain is more common immediately after the copper chain is implanted.
The chain is attached to the wall of the uterus with a small anchoring knot. This process leads to a small injury in the uterine muscle and can cause cramp-like pain as a result. Usually these symptoms go away within a few days. More severe pain can also be treated with medication with pain relievers (usually ibuprofen).

By and large, the rate of women who have a Gynefix removed because of permanent abdominal pain is extremely low.

What to do if the GyneFix has fallen out?

In very rare cases it can happen that the anchoring knot of the GyneFix® in the uterine wall comes loose and an expulsion occurs. There is an increased risk of the copper chain falling out, especially in the first few months and the first year of use. The GyneFix® was then often not properly attached, because rejection is unlikely if it was inserted correctly.

However, if you notice that the Gynefix has fallen out, you should immediately contact the gynecologist who inserted the copper chain and discuss how to proceed.

Using the retrieval thread, women can also repeatedly check whether the Gynefix is still properly anchored in the uterus. To do this, the hands are first washed thoroughly and then a finger is inserted into the vagina. At the top you can feel the loose end of the copper chain.

How is a copper chain removed again?

After five years of wearing, the GyneFix® must be removed or replaced.
A copper chain can only be removed by a gynecologist.

The best time to remove it is towards the end of your menstrual period, as the cervix is more open at this point.
The removal of the copper chain is a relatively quick and uncomplicated procedure that causes hardly any pain.
The doctor removes the GyneFix® with a quick, strong pull on the loose end of the chain. At the request of the patient, a new GyneFix® can be placed immediately.

Can you do an MRI with the copper chain?

Before having a magnetic resonance scan (MRI) or an X-ray, the doctor must be told that you are wearing a copper chain.
The GyneFix® contains parts of copper, which are not magnetically active and therefore cannot cause any problems during an MRI. Even so, the doctor should know in order to correctly interpret the imaging results.

Further information can be found at: Procedure of an MRI

What is the difference to the spiral?

A GyneFix® differs from a spiral in its structure. In contrast to the spiral, the copper chain has no plastic components, but the copper rings are strung on a surgical thread.
A GyneFix® is smaller than a conventional copper coil and can therefore adapt better to the uterus.

In contrast to a hormone coil, the GyneFix® is hormone-free. Therefore, there are no hormone-related side effects.

All information about the spiral can be found here: spiral