Patent Publication Number: US-2023157864-A1

Title: Packaging Systems for Implantable Devices and Related Methods

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of and claims priority under 35 U.S.C. § 120 to U.S. application Ser. No. 16/953,462, filed on Nov. 20, 2020, which claims priority to U.S. Provisional Patent Application No. 62/938,449, filed on Nov. 21, 2019. The entire contents of each of these priority applications are incorporated herein by reference. 
    
    
     TECHNICAL FIELD 
     This disclosure relates to packaging systems for implantable devices and related methods of handling such implantable devices using components of the packaging systems. 
     BACKGROUND 
     Intrauterine devices (IUDs) can be placed in the uterus of a patient as a form of contraceptive for preventing pregnancy. IUDs typically have a T-shape with arms extending perpendicularly to a shaft of the IUD. In some cases, to prepare an IUD for implantation, a healthcare provider must use his or her fingers to fold the arms of the IUD against the shaft and must maintain the arms in the folded configuration with his or her fingers while positioning an insertion tube over the arms in the folded configuration. However, due to the small size and surface area of the arms of the IUD, many healthcare providers have difficulty folding the arms using their fingers and maintaining the folded configuration of the arms long enough to pass the insertion tube over the arms of the IUD. 
     SUMMARY 
     This disclosure relates to packaging systems for implantable devices (e.g., IUDs) and related methods of handling such implantable devices using components of the packaging systems. 
     In one aspect, a loading device for securing an implantable device to a carrier member includes an elongate body configured to support the carrier member. The carrier member surrounds a shaft of the implantable device. The loading device further includes a first channel extending in a first direction from the elongate body and configured to receive a first arm of the implantable device that extends from the shaft and a second channel extending in a second direction from the elongate body and configured to receive a second arm of the implantable device that extends from the shaft, the second direction being opposite the first direction. The first and second channels are pivotable towards the elongate body respectively to move the first and second arms into a collapsed state against the shaft in which the first and second arms can be retained within the carrier member. 
     Embodiments may include one or more of the following features. 
     In some embodiments, the first and second channels are substantially perpendicular to the elongate body in an initial state or the first and second channels are positioned at an obtuse angle relative to the elongate body in an initial state. 
     In certain embodiments, the first and second channels are pivotable to fold the first and second arms into the collapsed state against the shaft to reduce a width of the implantable device such that the carrier member can further surround the first and second arms. 
     In some embodiments, the first and second channels are pivotable respectively at first and second hinges along the elongate body. 
     In certain embodiments, the implantable device is an intrauterine device, and the carrier member includes an insertion tube. 
     In some embodiments, the loading device further includes a receptacle extending from the elongate body and configured to retain the carrier member against the elongate body. 
     In certain embodiments, the receptacle includes flanges that are configured to retain the carrier member against the elongate body. 
     In some embodiments, the receptacle is configured to retain the carrier member in a slidable state against the elongate body. 
     In certain embodiments, the loading device further includes a string that can be pulled proximally to pivot the first and second channels towards the elongate body. 
     In some embodiments, the string is attached to a first end of the first channel and a second end of the second channel. 
     In certain embodiments, the string passes through the elongate body. 
     In another aspect, a method of preparing an implantable device for deployment includes accessing a loading device that is assembled with the implantable device and with a carrier member that surrounds a shaft of the implantable device. The loading device includes an elongate body supporting the carrier member, a first channel extending in a first direction from the elongate body and surrounding a first arm of the implantable device, and a second channel extending in a second, opposite direction from the elongate body and surrounding a second arm of the implantable device. The method further includes pivoting the first and second channels towards the elongate body respectively to move the first and second arms into a collapsed state against the shaft and placing the carrier member over the first and second arms to retain the first and second arms within the carrier member. 
     Embodiments may include one or more of the following features. 
     In some embodiments, sliding the carrier member over the first and second arms includes sliding the carrier member distally along the elongate body. 
     In certain embodiments, the loading device further includes a receptacle that extends from the elongate body and retains the carrier member against the elongate body. 
     In some embodiments, the method further includes lifting the carrier member, with the first and second arms of the implantable device retained therein, from the receptacle to remove the implantable device from the loading device. 
     In certain embodiments, the loading device further includes a string attached to a first end of the first channel and to a second end of the second channel. 
     In some embodiments, pivoting the first and second channels towards the elongate body respectively to move the first and second arms into a collapsed state against the shaft includes pulling the string proximally to pivot the first and second channels towards the elongate body. 
     In certain embodiments, the method further includes compressing a spring that abuts a proximal end of the loading device. 
     In some embodiments, the method further includes moving the loading device proximally against the spring. 
     In certain embodiments, the method further includes inserting the carrier member, carrying the implantable device with the first and second arms in the collapsed state, into a patient. 
     In some embodiments, the method further includes pulling the carrier member proximally with respect to the implantable device to release the first and second arms from the collapsed state. 
     In certain embodiments, the method further includes pushing the carrier member distally with respect to the implantable device to position the implantable device within the patient. 
     In some embodiments, the implantable device is an intrauterine device, and the carrier member includes an insertion tube. 
     In another aspect, a packaging system includes a loading device for securing an implantable device to a carrier member and a tray supporting the loading device. The loading device includes an elongate body configured to support the carrier member, the carrier member surrounding a shaft of the implantable device, a first channel extending in a first direction from the elongate body and configured to receive a first arm of the implantable device that extends from the shaft, and a second channel extending in a second direction from the elongate body and configured to receive a second arm of the implantable device that extends from the shaft, the second direction being opposite the first direction. The first and second channels are pivotable towards the elongate body respectively to move the first and second arms into a collapsed state against the shaft in which the first and second arms can be retained within the carrier member. 
     Embodiments may include one or more of the following features. 
     In some embodiments, the implantable device is an intrauterine device, and the carrier member includes an insertion tube. 
     In certain embodiments, the tray includes a first pair of flanges that secure the receptacle of the loading device to the tray. 
     In some embodiments, the tray includes a second pair of flanges that secure a distal end of the elongate body to the tray. 
     In certain embodiments, the tray defines a slot sized to accommodate the carrier member. 
     In some embodiments, the tray defines a inclined surface along which the first and second channels of the loading device can be pivoted. 
     In certain embodiments, the first and second channels are substantially perpendicular to the elongate body in an initial state. 
     In some embodiments, the first and second channels are pivotable to fold the first and second arms into the collapsed state against the shaft to reduce a width of the implantable device such that the carrier member can further surround the first and second arms. 
     In certain embodiments, the first and second channels are pivotable respectively at first and second hinges along the elongate body. 
     In some embodiments, the loading device further includes a receptacle extending from the elongate body and configured to retain the carrier member against the elongate body. 
     In certain embodiments, the receptacle includes flanges that are configured to retain the carrier member against the elongate body. 
     In some embodiments, the receptacle is configured to retain the carrier member in a slidable state against the elongate body 
     In certain embodiments, the packaging system further includes a string that can be pulled proximally to pivot the first and second channels towards the elongate body. 
     In some embodiments, the string is attached to a first end of the first channel and a second end of the second channel. 
     In certain embodiments, the string passes through the elongate body. 
     In some embodiments, the system further includes a spring that abuts a proximal end of the elongate body. 
     In certain embodiments, compression of the spring in a proximal direction permits proximal movement of the loading device against the spring. 
     In another aspect, a tray for securing an implantable device to a carrier member includes a first slot configured to retain the carrier member, wherein the carrier member surrounds a shaft of the implantable device. The tray further includes a first receptacle adjacent the slot and having a first width to receive first and second arms of the implantable device in an initial state in which the first and second arms extend substantially perpendicularly from the shaft. The tray further includes a second receptacle adjacent the first receptacle and having a second width for receiving the first and second arms of the implantable device in a collapsed state in which the first and second arms are folded against the shaft such that the carrier member can be slid over the first and second arms to retain the first and second arms, the second width being less than the first width. 
     In another aspect, a method of preparing an implantable device for deployment includes accessing a tray that is assembled with the implantable device and a with a carrier member that surrounds a shaft of the implantable device. The tray includes a first slot configured to retain the carrier member, a first receptacle adjacent the slot and having a first width to receive first and second arms of the implantable device in an initial state in which the first and second arms extend substantially perpendicularly from the shaft, and a second receptacle adjacent the first receptacle and having a second width for receiving the first and second arms of the implantable device in a collapsed state in which the first and second arms are folded against the shaft. The method further includes moving the implantable device distally from the first receptacle into the second receptacle, causing the first and second arms of the implantable device to move from the initial state to the collapsed state, and sliding the carrier member distally along the first slot and over the first and second arms to retain the first and second arms within the carrier member. 
     In another aspect, a tray for securing an implantable device to a carrier member includes a slot configured to retain the carrier member and a receptacle adjacent the slot. The carrier member surrounds a shaft of the implantable device. The receptacle has a first width at a proximal end of the receptacle to receive first and second arms of the implantable device in an initial state in which the first and second arms extend substantially perpendicularly from the shaft. The receptacle has a second width at a distal end of the receptacle for receiving the first and second arms of the implantable device in a collapsed state in which the first and second arms are folded against the shaft such that the carrier member can be slid over the first and second arms to retain the first and second arms. The second width is less than the first width. 
     Embodiments may include one or more of the following features. 
     In some embodiments, the tray defines one or more flanges configured to secure the carrier member to the tray. 
     In certain embodiments, the tray includes a main body defining the slot and a loading aid defining the receptacle, the loading aid being coupled to a distal portion of the main body. 
     In some embodiments, the loading aid includes a first wall and a second wall opposite the first wall. The first and second walls are formed to guide the first and second arms of the implantable device into the collapsed state upon distal movement of the implantable device within the receptacle 
     In certain embodiments, the receptacle has a tapered shape. 
     In some embodiments, the implantable device includes an intrauterine device, and the carrier member includes an insertion tube. 
     In certain embodiments, the receptacle is a first receptacle, and the tray further defines a second receptacle adjacent the slot and opposite the first receptacle, the second receptacle being configured to receive a handle that is coupled to the carrier member 
     In some embodiments, the second receptacle is longer than the handle to permit distal movement of the handle within the second receptacle. 
     In certain embodiments, the tray further defines a gripping region positioned along the slot, the gripping region being wider than the slot. 
     In some embodiments, the tray includes ruler markings adjacent the gripping region, the ruler markings indicating respective uterine depths. 
     In certain embodiments, the tray includes a first support body defining the receptacle and a second support body slidably coupled to the first support body. 
     In some embodiments, the first support body defines an elongate platform slidably coupled to the second support body and a shoulder configured to prevent distal movement of the second support body relative to the first support body beyond the shoulder. 
     In certain embodiments, distal movement of the second support body relative to the first support body causes the implantable device to move distally within the receptacle from the proximal end of the receptacle to the distal end of the receptacle to cause the first and second arms of the implantable device to move from the initial state into the collapsed state. 
     In another aspect, a packaging system includes a tray for securing an implantable device to a carrier member and a protective cover formed complementary to at least a portion of the tray for securing a handle that is coupled to the carrier member to the tray. The tray includes a slot configured to retain the carrier member and a receptacle adjacent the slot. The carrier member surrounds a shaft of the implantable device. The receptacle has a first width at a proximal end of the receptacle to receive first and second arms of the implantable device in an initial state in which the first and second arms extend substantially perpendicularly from the shaft. The receptacle has a second width at a distal end of the receptacle for receiving the first and second arms of the implantable device in a collapsed state in which the first and second arms are folded against the shaft such that the carrier member can be slid over the first and second arms to retain the first and second arms. The second width is less than the first width. 
     Embodiments may include one or more of the following features. 
     In some embodiments, the tray defines one or more flanges configured to secure the carrier member to the tray. 
     In certain embodiments, the tray includes a main body defining the slot and a loading aid defining the receptacle, the loading aid being coupled to a distal portion of the main body. 
     In some embodiments, the loading aid includes a first wall and a second wall opposite the first wall. The first and second walls are formed to guide the first and second arms of the implantable device into the collapsed state upon distal movement of the implantable device within the receptacle. 
     In certain embodiments, the receptacle has a tapered shape. 
     In some embodiments, the tray further defines a gripping region positioned along the slot, the gripping region being wider than the slot. 
     In another aspect, a method of preparing an implantable device for deployment includes accessing a tray that is assembled with the implantable device and with a carrier member that surrounds a shaft of the implantable device. The tray defines a slot configured to retain the carrier member and a receptacle adjacent the slot. The carrier member surrounds a shaft of the implantable device. The receptacle has a first width at a proximal end of the receptacle to receive first and second arms of the implantable device in an initial state in which the first and second arms extend substantially perpendicularly from a shaft of the implantable device. The receptacle has a second width at a distal end of the receptacle for receiving the first and second arms of the implantable device in a collapsed state in which the first and second arms are folded against the shaft. The second width is less than the first width. The method further includes moving the implantable device distally from the proximal end of the receptacle to the distal end of the receptacle, causing the first and second arms of the implantable device to move from the initial state to the collapsed state, and sliding the carrier member distally along the slot and over the first and second arms to retain the first and second arms within the carrier member. 
     The details of one or more embodiments of the invention are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the invention will be apparent from the description and drawings, and from the claims. 
    
    
     
       DESCRIPTION OF DRAWINGS 
         FIG.  1    is a perspective view of an intrauterine device (IUD) positioned in a uterus of a patient. 
         FIG.  2    is a perspective view of a portion of a packaging system that houses the IUD of  FIG.  1    and an insertion tube. 
         FIG.  3    is a perspective view of a portion of the packaging system of  FIG.  2   . 
         FIG.  4    is a perspective view of a loading device of the packaging system of  FIG.  2   . 
         FIG.  5    is a front view of the loading device of  FIG.  4   . 
         FIG.  6    is an enlarged perspective view of a portion of the loading device of  FIG.  4   . 
         FIGS.  7 - 11    illustrate a method of using the packaging system of  FIG.  2    to secure the IUD of  FIG.  1    to the insertion tube of  FIG.  2   . 
         FIG.  12    is a perspective view of the IUD of  FIG.  1    secured to the insertion tube of  FIG.  2    in a folded configuration. 
         FIGS.  13 - 15    illustrate a method of implanting the IUD of  FIG.  1    into the uterus of a patient using the insertion tube of  FIG.  2   . 
         FIG.  16    is a perspective view of a portion of a packaging system for securing the IUD of  FIG.  1    to the insertion tube of  FIG.  2   . 
         FIGS.  17 - 20    illustrate a method of securing the IUD of  FIG.  1    to the insertion tube of  FIG.  2    using the packaging system of  FIG.  16   . 
         FIG.  21    is a perspective view of a portion of a packaging system that houses the IUD of  FIG.  1    along with the insertion tube of  FIG.  2   . 
         FIGS.  22 - 24    illustrate a method of securing the IUD of  FIG.  1    to the insertion tube of  FIG.  2    using the packaging system of  FIG.  21   . 
         FIG.  25    is a perspective view of a loading device for securing the IUD of  FIG.  1    to the insertion tube of  FIG.  2   . 
         FIG.  26    is a perspective view of a packaging system for securing the IUD of  FIG.  1    to the insertion tube of  FIG.  2   . 
         FIGS.  27 - 29    illustrate a method of securing the IUD of  FIG.  1    to the insertion tube of  FIG.  2    using the packaging system of  FIG.  26   . 
         FIG.  30    is a top view of the distal portion of the packaging system of  FIG.  26   . 
         FIG.  31    is a perspective view of a packaging system for securing the IUD of  FIG.  1    to the insertion tube of  FIG.  2   . 
         FIG.  32    is an exploded perspective view of the packaging system of  FIG.  31   . 
     
    
    
     DETAILED DESCRIPTION 
       FIG.  1    illustrates an intrauterine device (IUD)  100  positioned within a uterus  102  of a patient. When implanted in the uterus  102  of the patient, the IUD  100  acts as a contraceptive device for preventing pregnancy. The IUD  100  includes a shaft  104  and a pair of arms  106 ,  108  extending from the shaft  104 . As shown in  FIG.  1   , when the IUD  100  is properly positioned within the uterus  102 , the arms  106 ,  108  of the IUD  100  are substantially perpendicular to the shaft  104  and are positioned along a wall (e.g., a fundus) of the uterus  102 . 
     The IUD  100  also includes a copper wire  112  that is secured to the shaft  104  and copper collars  114 ,  116  that are respectively secured to the arms  106 ,  108  of the IUD  100 . For example, the copper wire  112  and copper collars  114 ,  116  can release copper into the uterus  102 , where such copper functions as a contraceptive to prevent pregnancy in the patient. The IUD  100  can remain in the uterus  102  for an extended period (e.g., up to about 10 years) and provides continuous contraception while the IUD  100  is positioned within the uterus  102 . 
     The IUD  100  also includes one or more threads  110  extending from an end of the shaft  104  that is opposite from the arms  106 ,  108 . The threads  110  can be manipulated to remove the IUD  100  from the uterus  102 . In some examples, the threads  110  are trimmed to a shorter length following implantation of the IUD  100  in the uterus  102 . In some examples, the shaft  104  of the IUD  100  has a length of about 3.1 cm to about 3.3 cm (e.g., about 3.20 cm) and a diameter of about 0.14 cm to about 0.17 cm (e.g., about 0.152 cm). In some examples, each of the arms  106 ,  108  of the IUD  100  has a length of about 1.52 cm to about 1.53 cm (e.g., about 1.524 cm) and a diameter of about 0.15 cm to about 0.17 cm (e.g., about 0.157 cm). Example materials from which the IUD  100  may be made include polypropylene and copper. 
       FIGS.  2  and  3    illustrate a packaging system  200  that houses the IUD  100  and an insertion tube  202  that can be used to implant the IUD  100  within the uterus  102  the patient. The insertion tube  202  is marked with ruled markings  262  and is equipped with a movable indicator  260 , as will be discussed in more detail below. The packaging system  200  also houses a rod  235  that is positioned within the insertion tube  202  and that is used to implant the IUD  100 , which also be discussed in more detail below. 
     The packaging system  200  includes a tray  206 , a loading device  204  that is secured to the tray  206 , and a lid (not shown) that covers the tray  206 . The loading device  204  can be used to secure the IUD  100  to the insertion tube  202  for implanting the IUD  100  within the uterus  102  of the patient. The loading device  204  includes an elongate body  220 , a receptacle  212  that extends from one end of the elongate body  220 , and two arms  236 ,  238  that extend substantially perpendicular from an opposite end of the elongate body  220  in an initial configuration, as will be discussed in more detail below with respect to  FIGS.  4 - 6   . The tray  206  includes a first pair of flanges  208 ,  210  that secure the receptacle  212  of the loading device  204  to the tray  206  and a second pair of flanges  214 ,  216  that secure a distal end  218  of the elongate body  220  of the loading device  204  to the tray  206  in a pre-packaged configuration. The loading device  204  can be removed from the tray  206  without damaging the loading device  204  or the tray  206 . 
     As depicted in  FIG.  2   , the tray  206  defines a slot  222  that accommodates the insertion tube  202 . The slot  222  is sized to allow the insertion tube  202  to move axially within the slot  222  along the length of the slot  222  and to substantially restrict lateral movement the insertion tube  202  within the slot  222 . The slot  222  also defines opposing flanges  290 ,  292  (shown in  FIG.  9   ) that narrow an opening of the slot  222  to prevent the insertion tube  202  from popping out of the slot  222 . In some examples, the slot  222  has a length of about 2.7 cm to about 3.1 cm (e.g., about 2.90 cm), a width of about 0.48 cm to about 0.53 cm (e.g., about 0.51 cm), and a depth of about 0.63 cm to about 0.68 cm (e.g., about 0.66 cm). 
     The tray  206  further defines a recessed region  224  along the slot  222  that provides space for a user&#39;s fingers to access (e.g., grip) the insertion tube  202 . For example, a healthcare provider can grasp a portion of the insertion tube  202  positioned within the gripping region  224  with his or her fingers and slide the insertion tube  202  distally along the slot  222  over folded arms  106 ,  108  of the IUD  100 , as will be discussed in more detail below with respect to  FIGS.  9  and  10   . In some examples, the gripping region  224  defined within the tray  206  has a length of about 4.2 cm to about 4.4 cm (e.g., about 4.31 cm), a width of about 3.9 cm to about 4.1 cm (e.g., about 4.00 cm), and a depth of about 0.9 cm to about 1.0 cm (e.g., about 0.95 cm). In some examples, a proximal end  226  of the gripping region  224  is positioned about 5.2 cm to about 5.4 cm (e.g., about 5.27 cm) apart from a proximal end  228  of the tray  206 . 
     The tray  206  further defines a circular depression  230  adjacent the slot  222  and adjacent the proximal end  228  of the tray  206 . The circular depression  230  accommodates a circular end portion  232  of a rod  235  that extends within the insertion tube  202  from the end portion  232  to a proximal end of the shaft  104  of the IUD. The rod  235  is used to assist with positioning the IUD  100  within the uterus  102 . In some examples, the circular depression  230  defined within the tray  206  has an outer diameter of about 2.2 cm to about 2.4 cm (e.g., about 2.26 cm), a depth of about 0.5 cm to about 0.7 cm (e.g., about 0.58 cm), and a width (e.g., the distance from an outer wall of the circular depression  230  to an inner wall of the circular depression  230 ) of about 0.2 cm to about 0.4 cm (e.g., about 0.27 cm). 
     Still referring to  FIG.  2   , the tray  206  also defines a inclined surface  234  that supports the loading device  204 . The inclined surface  234  provides a recessed region that allows for pivoting of the arms  236 ,  238  of the loading device  204  in order to fold the arms  106 ,  108  of the IUD  100  inward, as will be discussed in more detail below with respect to  FIGS.  4 - 8   . The inclined surface  234  includes an upper portion  240  and a lower portion  242 . The upper portion  240  of the inclined surface  234  has a generally semicircular shape, and the lower portion  242  of the inclined surface  234  has a generally rectangular shape. In some examples, the lower portion  242  of the inclined surface  234  has a length of about 5.3 cm to about 5.5 cm (e.g., about 5.39 cm) and a width of about 4.4 cm to about 4.7 cm (e.g., about 4.56 cm). In some examples, the lower portion  242  is oriented at an angle of about 164 degrees to about 174 degrees (e.g., about 169 degrees) with respect to the upper portion  240 . 
     The tray  206  is typically made of one or more polymer materials. Example materials from which the tray  206  can be made include polystyrene, polypropylene, and PETG (polyethylene terephthalate glycol), ABS (acrylonitrile butadiene styrene), HDPE (high density polyethylene), LDPE (low density polyethylene). Example processes for forming the tray  206  include injection molding, vacuum forming, pressure forming, and die cut cards. In some examples, the tray  206  has a total length of about 28.3 cm to about 29.9 cm (e.g., about 29.1 cm), a total width of about 22.6 cm to about 24.2 cm (e.g., about 23.4 cm), and a total height of about 0.9 cm to about 1.1 cm (e.g., about 0.98 cm). 
     Referring to  FIG.  3   , the packaging system  200  also may include an insert  302  for helping to retain the IUD  100  against the loading device  204 . The insert  302  includes a proximal body  316 , a distal body  304 , and a pair of projections  306 ,  308  extending from a distal end  310  of the distal body  304 . The insert  302  helps prevent movement and dislodgement of the IUD  100  from the loading device  204  during transit of the packaging system  200  and prior to preparation of the IUD  100  for implantation. The arms  106 ,  108  of the IUD  100  are positioned within channels  244 ,  246  defined by the arms  236 ,  238  of the loading device  204 . The distal body  304  of the insert  302  can be positioned over the shaft  104  of the IUD  100 , and each of the projections  306 ,  308  of the insert  302  can be positioned under a respective arm  106 ,  108  of the IUD  100  to prevent the arms  106 ,  108  from sliding out of the channels  244 ,  246  prior to preparation of the IUD  100  for implantation. The insert  302  is removed from the tray  206  prior to preparing the IUD  100  for implantation to allow for movement and folding of the arms  106 ,  108  of the IUD  100 . For example, the insert  302  can be removed from the tray  206  by pulling proximally on a proximal end  314  of the proximal body  316  to slide the insert  302  proximally away from the loading device  204  and thus slide the projections  306 ,  308  of the insert  302  out from under the arms  106 ,  108  of the IUD  100 . 
     The insert  302  can include one or both of written and graphical instructions  318  for preparing the IUD  100  for implantation. As shown in  FIG.  3   , the instructions  318  for preparing the IUD  100  may be printed on the proximal body  316  of the insert  302 , or in other cases, the instructions  318  may be printed on the distal body  304  of the insert  302   
     The insert  302  is typically transparent in appearance. For example, either or both of the proximal body  316  and the distal body  304  of the insert  302  is typically made of one or more plastic materials, such as high impact polystyrene (HIPS), polyethylene terephthalate glycol, acrylonitrile butadiene styrene (ABS), high density polyethylene (HDPE), or one or more paper materials. In some examples, the insert  302  is manufactured using one or more processes, such as thermoforming, die-cutting and injection molding and heat staking. The distal and proximal bodies  304 ,  316  of the insert  302  typically have a combined length of about 27.0 cm to about 27.3 cm (e.g., about 27.13 cm), a width of about 4.2 cm to about 4.4 cm (e.g., about 4.32 cm), and a thickness of about 0.03 cm to about 0.05 cm (e.g., about 0.04 cm). Each of the projections  306 ,  308  typically has a length of about 1.3 cm to about 1.5 cm (e.g., about 1.44 cm), a width of about 1.4 cm to about 1.6 cm (e.g., about 1.51 cm), and a thickness of about 0.03 cm to about 0.05 cm (e.g., about 0.04 cm). 
       FIGS.  4 - 6    illustrate various views of the loading device  204  for securing the IUD  100  to the insertion tube  202 . As depicted in  FIGS.  4  and  5   , the loading device  204  is generally T-shaped. As described above with respect to  FIG.  2   , the loading device  204  includes the elongate body  220 , the arms  236 ,  238 , and the receptacle  212 . The elongate body  220  extends along the length of the shaft  104  of the IUD  100 . The pair of arms  236 ,  238  extend from the distal end  218  of the elongate body  220 , and the receptacle  212  is positioned at the end of the elongate body  220 , opposite the arms  236 ,  238 , as discussed above. In some examples, the elongate body  220  has a maximum width of about 0.2 cm to about 0.5 cm (e.g., about 0.44 cm) and a length of about 1.9 cm to about 9.5 cm (e.g., about 3.25 cm). 
     The arms  236 ,  238  respectively extend from the distal end  218  of the elongate body  220  at flexible locations  254 ,  256  (e.g., hinges). As depicted in  FIGS.  4  and  5   , the arms  236 ,  238  are each substantially perpendicular to the elongate body  220  in an initial configuration (e.g., in a packaged state). In some embodiments, the arms  236 ,  238  are positioned at an obtuse angle with respect to the elongate body  220 . For example, the arms  236 ,  238  are typically oriented at an angle about 90 degrees to about 120 degrees (e.g., about 90 degrees) relative to a longitudinal axis  280  of the elongate body  220  in the initial configuration. In some examples, each arm  236 ,  238  has a total width of about 0.02 cm to about 0.50 cm (e.g., about 0.19 cm), a length of about 2.1 cm to about 2.3 cm (e.g., about 2.18 cm), and a total height of about 0.5 cm to about 1.0 cm (e.g., about 0.72 cm). The arms  236 ,  238  provide relatively large contact surfaces (e.g., the upper surfaces of the arms  236 ,  238 ) for the user&#39;s fingers as compared to surfaces of the arms  106 ,  108  of the IUD  100 . The large contact surfaces of the arms  236 ,  238  provide gripping regions that facilitate manipulation of the arms  106 ,  108  by the user, as compared to manipulation of the arms  106 ,  108  by conventional means of direct contact with the arms  106 ,  108 . 
     The arms  236 ,  238  respectively define channels  244 ,  246  along the lengths of the arms  236 ,  238 . As depicted in  FIG.  4   , the channels  244 ,  246  respectively surround the arms  106 ,  108  of the IUD  100  when the IUD  100  is positioned on the loading device  204  in the packaged state. The arm  236  includes flanges  248   a,    248   b  that in part define the channel  244 . Similarly, the arm  238  includes flanges  250   a,    250   b  that in part define the channel  246 . With the proximal end of the shaft  104  supported by the rod  235  and the insertion tube  202 , and with the arms  106 ,  108  positioned within the channels  244 ,  246 , a position of the IUD  100  is substantially maintained along the loading device  204  with limited movement during preparation of the IUD  100  for implantation, which will be discussed in more detail below. Furthermore, the channels  244 ,  246  are sized such that the arms  106 ,  108  of the IUD  100  can be easily released from the channels  244 ,  246  when necessary during preparation of the IUD  100  for implantation, as will be discussed in more detail below. As shown in  FIG.  4   , the arms  106 ,  108  extend past ends of the channels  244 ,  246 . In some examples, each of the channels  244 ,  246  has a width of about 0.9 cm to about 1.0 cm (e.g., about 0.94 cm), a height of about 0.4 cm to about 0.5 cm (e.g., about 0.42 cm), and a depth of about 0.2 cm to about 0.3 cm (e.g., about 0.28 cm). 
     As depicted in  FIGS.  4  and  5   , each of the arms  236 ,  238  are pivotably attached to the elongate body  220  by a respective flexible location  254 ,  256 . The flexible locations  254 ,  256  permit the arms  236 ,  238  to pivot radially inward towards the elongate body  220 . For example, the flexible locations  254 ,  256  allow the arms  236 ,  238  to be moved between a position substantially perpendicular to the elongate body  220  and a position substantially parallel to the elongate body  220 . When sufficient rotationally directed forces are applied to the arms  236 ,  238 , the flexible locations  254 ,  256  deform to permit the arms  236 ,  238  to fold inward towards the elongate body  220 . The flexible locations  254 ,  256  are flexible such that the flexible locations  254 ,  256  can remain functional (e.g., substantially mechanically intact) over multiple pivoting movements of the arms  236 ,  238  (e.g., such that the arms  236 ,  238  can be pivoted at least three times while the flexible locations  254 ,  256  remain intact). In some examples, each of the flexible locations  254 ,  256  has a width of about 0.1 cm to about 0.2 cm (e.g., about 0.16 cm), a height of about 0.7 cm to about 1.0 cm (e.g., about 0.72 cm), and a thickness of about 0.02 cm to about 0.06 cm (e.g., about 0.04 cm). 
     The receptacle  212  defines a channel  252  that supports the insertion tube  202 . For example, the channel  252  is formed to prevent the insertion tube  202  from falling out or otherwise becoming dislodged from the receptacle  212  during transportation of the packaging system  200 . The channel  252  is sized to permit the insertion tube  202  to slide axially within the channel  252  while restricting lateral movement of the insertion tube  202 . For example, a healthcare provider can use his or her fingers to slide the insertion tube  202  along the channel  252  of the receptacle  212  to cover ends of the arms  236 ,  238  of the IUD  100  when the arms  236 ,  238  are in a folded state, as will be discussed in more detail below. The channel  252  is sized and shaped such that the insertion tube  202  can be detached from the loading device  204  without damaging the insertion tube  202  or the loading device  204 . For example, the insertion tube  202  can be pulled upward from the receptacle  212  to remove the insertion tube  202  from the loading device  204  when needed. In some examples, the channel  252  has an interior width of about 0.4 cm to about 0.5 cm (e.g., about 0.45 cm), a length of about 1.1 cm to about 1.3 cm (e.g., about 1.19 cm), and a depth of about 0.4 cm to about 0.5 cm (e.g., about 0.45 cm). 
     As depicted in  FIGS.  4 - 6   , the channel  252  is defined by a pair of flanges  282 ,  284  on the receptacle  212 . The flanges  282 ,  284  define an elongate opening  286  of the channel  252  that is narrower than a width of the insertion tube  202 , such that the flanges  282 ,  284  retain the insertion tube  202  within the channel  252  during transit and preparation of the IUD  100  for implantation. In some examples, each of the flanges  282 ,  284  of the receptacle  212  has a width (excluding protrusions  268 ,  270 ) of about 0.1 cm to about 0.3 cm (e.g., about 0.20 cm), a length of about 0.9 cm to about 1.1 cm (e.g., about 1.01 cm), and a height of about 0.3 cm to about 0.4 cm (e.g., about 0.37 cm). In some examples, the elongate opening  286  has a width of about 0.4 cm to about 0.5 cm (e.g., about 0.45 cm). 
     The flanges  282 ,  284  respectively define protrusions  268 ,  270  along the elongate opening  286  of the channel  252  that help to retain the insertion tube  202  in the channel  252 . As depicted in  FIG.  6   , the protrusions  268 ,  270  are offset from each other along the length of the channel  252 . In some examples, each of the protrusions  268 ,  270  has a length of about 0.2 cm to about 0.4 cm (e.g., about 0.3 cm), and axial centers of the protrusions  268 ,  270  are offset from each other by a distance of about 0.1 cm to about 0.4 cm (e.g., about 0.39 cm). 
     The loading device  204  is typically made of one or more materials that are sufficiently compliant and resistant to plastic deformation to allow for repeated bending of the flexible locations  254 ,  256 . For example, such materials may behave more rigidly in a relatively thicker cross section of the elongate body  220  and behave more elastically in a relatively thinner cross sections at the flexible locations  254 ,  256 . Accordingly, the loading device  204  is typically made of one or more polymer materials, such as polypropylene, polyethylene, and thermoplastic elastomers (e.g., vulcanized ethylene propylene diene monomer (EPDM) rubber). Example processes for manufacturing the loading device  204  include injection molding, plastic machining, and 3D printing. 
       FIGS.  7 - 11    illustrate a method of securing the IUD  100  to the insertion tube  202  using the packaging system  200 . As previously discussed, the IUD  100  is packaged with the arms  106 ,  108  within the channels  244 ,  246  of the arms  236 ,  238  of the loading device  204  and with the shaft  104  extending into the insertion tube  202 . The insertion tube  202  is itself secured in the receptacle  212  of the loading device  204  and in the slot  222  of the tray  206 , and the rod  235  extends within the insertion tube  202  to the proximal end of the shaft  104  of the IUD  100 . 
     Referring to  FIG.  7   , a user (e.g., a healthcare provider) can use his or her fingers to push the arms  236 ,  238  of the loading device  204  (e.g., with the arms  106 ,  108  of the IUD  100  positioned therein) inwards towards the elongate body  220  to fold the arms  106 ,  108  towards the shaft  104  of the IUD  100 . 
     Referring to  FIG.  8   , the user maintains a force against the arms  236 ,  238  (e.g., squeezes the arms  236 ,  238  together) until the arms  236 ,  238  are substantially parallel to the elongate body  220  such that the arms  106 ,  108  of the IUD  100  are collapsed against the shaft  104  of the IUD  100 . For example, when the channels  244 ,  246  of the arms  236 ,  238  are positioned substantially parallel to the elongate body  220 , the arms  106 ,  108  of the IUD  100  are folded against and substantially parallel to the shaft  104  of the IUD  100 . 
     Referring to  FIG.  9   , once the arms  106 ,  108  of the IUD  100  are folded against the shaft  104  of the IUD  100 , the insertion tube  202  is moved distally along the slot  222  of the tray  206  and the channel  252  of the receptacle  212  towards the IUD  100 . For example, the user can grasp a portion of the insertion tube  202  positioned within the recessed gripping region  224  of the tray  206  and slide the insertion tube  202  distally towards the loading device  204  while maintaining the arms  236 ,  238  parallel to the elongate body  220 . The insertion tube  202  is slid distally until the distal end of the insertion tube  202  slides over proximal ends of the folded arms  106 ,  108  that extend past ends of the channels  244 ,  246  of the arms  236 ,  238  of the loading device  204 . 
     Referring to  FIG.  10   , sliding the insertion tube  202  over the arms  106 ,  108  of the IUD  100  captures and maintains the arms  106 ,  108  in the folded positions against the shaft  104 . Once the insertion tube  202  has been positioned over the arms  106 ,  108 , the user can release the arms  236 ,  238  of the loading device  204  from his or her fingers to allow the arms  236 ,  238  to flexibly pivot away from the IUD  100 . If one or both of the arms  106 ,  108  of the IUD  100  are not appropriately positioned within the insertion tube  202  at this point, then the user can slide the insertion tube  202  proximally back towards an initial position, and the process described with respect to  FIGS.  7 - 10    can be repeated until the proximal ends of the arms  106 ,  108  of the IUD are securely positioned within the insertion tube  202 . 
     Referring to  FIG.  11   , once the arms  106 ,  108  of the IUD  100  are secured within the insertion tube  202 , the insertion tube  202 , carrying the IUD  100 , is removed from sequentially from the tray  206  and from the loading device  204 . For example, the user can grasp a portion of the insertion tube  202  positioned in the gripping region  224  with his or her fingers and lift the insertion tube  202  out of the slot  222  in the tray  206  and out of the receptacle  212  of the loading device  204 . Since the arms  106 ,  108  of the IUD  100  are secured to the insertion tube  202 , the IUD  100  is also removed along with the insertion tube  202 . 
     Referring to  FIG.  12   , the IUD  100  is now prepared for implantation (e.g., deployment) within the patient. As depicted, the arms  106 ,  108  of the prepared IUD  100  are folded against the shaft  104  of the IUD  100 , and a portion of each of the arms  106 ,  108  of the IUD  100  is contained within the insertion tube  202 . Furthermore, a portion of the shaft  104  of the IUD  100  is also captured within the insertion tube  202 . 
       FIGS.  13 - 15    illustrate a method of implanting the IUD  100  into the uterus  102  of the patient using the insertion tube  202  and the rod  235  (e.g., positioned within the insertion tube  202 ). Prior to inserting the IUD  100  into the uterus  102 , the depth of the uterus  102  (e.g., of the uterine cavity) is measured by inserting a sterile uterine sound into the uterus  102 . The measurement indicator  260  is moved along the insertion tube  202  to be aligned with a ruler marking  262  on the insertion tube  202  that corresponds to the depth measurement determined using the uterine sound. When the IUD  100  is properly positioned at the fundus  134  of the uterus  102 , the measurement indicator  260  is positioned against (e.g., abuts) the cervix  186  of the patient, as depicted in  FIG.  13   . In this manner, the measurement indicator  260  ensures proper positioning of the insertion tube  202  and the IUD  100  within the uterus  102 . Once the measurement indicator  260  is aligned with the proper ruler marking  262 , the rod  235  (e.g., already positioned within the insertion tube  202 ) is adjusted to contact the proximal end of the shaft  104  of the IUD  100 . 
     Referring to  FIG.  13   , the insertion tube  202 , carrying the IUD  100 , is passed through the cervical canal into the uterus  102  until the IUD  100  touches the fundus  134  of the uterus. When the distal end of the IUD  100  is properly positioned against the fundus  134  of the uterus  102 , the measurement indicator  260  abuts the cervix  186  of the patient, as depicted in  FIG.  13   . 
     Referring to  FIG.  14   , once the insertion tube  202  is positioned in the cervical canal such that the exposed end of the IUD  100  is touching the fundus  134  of the uterus, the insertion tube  202  is pulled proximally away from the IUD  100  until the arms  106 ,  108  of the IUD  100  are released from the insertion tube  202 . The rod  235  inside of the insertion tube  202  is held steady while the insertion tube  202  is pulled proximally to release the arms  106 ,  108  of the IUD  100 . For example, the insertion tube  202  may be pulled proximally until the proximal end of the insertion tube  202  contacts the end portion  232  (shown in  FIG.  2   ) of the rod  235 . In some examples, the insertion tube  202  is pulled proximally by a distance of about 0.4 cm to about 0.6 cm (e.g., about 0.5 cm) to release the arms  106 ,  108  of the IUD  100 . 
     Referring to  FIG.  15   , once the arms  106 ,  108  of the IUD  100  are released from the insertion tube  202 , the insertion tube  202  is moved distally further into the uterus  102  to push the IUD  100  towards the fundus  134  to ensure that the arms  106 ,  108  of the IUD  100  are placed at the deepest position in the uterus  102  (e.g., against the fundus  134  of the uterus  102 ). 
     After ensuring proper placement of the IUD  100  in the uterus  102 , the rod ( 235  and the insertion tube  202  are removed from the cervical canal of the patient. In some examples, the rod  235  is first removed from the patient while the insertion tube  202  is held steady, and the insertion tube  202  is then removed after removing the rod  235 . In some examples, after removal of the insertion tube  202  from the patient, the one or more threads  110  (shown in  FIG.  1   ) coupled to the shaft  104  are trimmed. In some implementations, the threads of the IUD  100  are trimmed so that a length of about 1.5 cm to about 2.0 cm (e.g., about 2.0 cm) of the one or more threads extend out the cervical canal and into the vagina of the patient. 
     While certain embodiments have been described above, other embodiments are possible. For example, while the packaging system  200  for securing an intrauterine device  100  to an insertion tube  202  has been described and illustrated as including a loading device  204  with pivotable arms  236 ,  238 , in some embodiments, a system that is similar in function to the system  200  includes a one or more receptacles sized to fold the arms  106 ,  108  of an IUD  100  rather than a loading device  204  with pivotable arms  236 ,  238 . Referring to  FIGS.  16  and  17   , a packaging system  400  that houses an IUD  100  is designed for securing the IUD  100  to an insertion tube  202 . The packaging system  400  includes a tray  406  defining multiple depressions, including a slot  422 , a first receptacle  402 , a second receptacle  404 , a gripping region  424 , and a proximal depression  430 . In some examples, the tray  406  has a length of about 28.3 cm to about 29.9 cm (e.g., about 29.1 cm), a width of about 22.6 cm to about 24.2 cm (e.g., about 23.4 cm), and a height of about 0.9 cm to about 1.1 cm (e.g., about 0.98 cm). 
     As depicted in  FIG.  16   , the slot  422  extends along the length of the tray  406 . The slot  422  accommodates an insertion tube  202  and restricts lateral movement and angular movement of the insertion tube  202  outside the slot  422 . In some examples, the slot  422  has a length of about 2.9 cm to about 3.4 cm (e.g., about 3.15 cm), a width of about 0.48 cm to about 0.53 cm (e.g., about 0.51 cm), and a depth of about 0.63 cm to about 0.68 cm (e.g., about 0.66 cm). 
     The tray  406  also include flanges  440 ,  442 ,  444 ,  446  positioned adjacent to the slot  422  along the length of the slot  422 . The flanges  440 ,  442 ,  444 ,  446  narrow an axial opening of the slot  422  to help retain the insertion tube  202  in the slot  422  and prevent dislodgement of the insertion tube  202  from the tray  406  during transit of the system  400  prior to preparation of the IUD  100  for implantation. The insertion tube  202  can be detached from the tray  406  without damaging the insertion tube  202  or the tray  406 . 
     The tray  406  defines a first receptacle  402  located adjacent the distal end of the slot  422 . The first receptacle  402  accommodates the arms  106 ,  108  of the IUD  100  in an initial configuration (e.g., a packaged state) in which the arms  106 ,  108  are substantially perpendicular to the shaft  104  of the IUD  100 , as depicted in  FIG.  17   . For example, a width  408  of the first receptacle  402  is larger than the distance between the end of the first arm  106  and the end of the second arm  108  when the arms  106 ,  108  are substantially perpendicular to the shaft  104  of the IUD  100 . In some examples, the first receptacle  402  has a width of about 4.4 cm to about 4.6 cm (e.g., about 4.50 cm), a length of about 1.4 cm to about 1.6 cm (e.g., about 1.50 cm), and a depth of about 7.8 cm to about 7.9 cm (e.g., about 7.85 cm). 
     Referring to  FIGS.  16  and  17   , the second receptacle  404  is located adjacent to the first receptacle  402  and to the distal end  410  of the tray  406 . The second receptacle  404  has a minimum width  412  sized to receive the arms  106 ,  108  of the IUD  100  in a collapsed or folded state (as depicted in  FIG.  19   ). For example, the second receptacle  404  is formed as a generally triangular-shaped depression that narrows to the width  412  near the distal end  410  of tray  406 . The shape of second receptacle  404  causes the arms  106 ,  108  of the IUD  100  to be pushed inwards towards the shaft  104  of the IUD  100  through contact with tapered walls  414 ,  416  of the second receptacle  404  as the IUD  100  is pushed distally through the second receptacle  404 . The second receptacle  404  also defines a floor  420  that supports the IUD  100  as the IUD is moved distally along the second receptacle  404 . 
     The gripping region  424  provides space for a user to grasp a portion of the insertion tube  202  positioned within the gripping region  424  with his or her fingers and slide the insertion tube  202  distally along the slot  422  to capture the folded arms  106 ,  108  of the IUD  100  within the insertion tube  202 . In some examples, the gripping region  424  defined within the tray  406  has a length of about 4.2 cm to about 4.4 cm (e.g., about 4.31 cm), a width of about 3.9 cm to about 4.1 cm (e.g., about 4.0 cm), and a depth of about 0.9 cm to about 1.0 cm (e.g., about 0.95 cm). In some examples, a proximal end  426  of the gripping region  224  is positioned about 12.6 cm to about 12.8 cm (e.g., about 12.7 cm) apart from a proximal end  428  of the tray  406 . 
     The tray  406  further defines a proximal depression  430  located near the proximal end  428  of the tray  406 . The proximal depression  430  accommodates the end portion  232  of a rod  235  used to push the IUD  100  positioned in the first receptacle  402  through the second receptacle  404 . In some examples, the proximal depression  430  defined within the tray  406  has a length of about 4.8 cm to about 5.0 cm (e.g., about 4.9 cm) and a depth of about 0.9 cm to about 1.0 cm (e.g., about 0.95 cm). In some examples, the width of the depression forming the proximal depression  430  is about 3.9 cm to about 4.1 cm (e.g., about 4.0 cm). 
       FIGS.  17 - 19    illustrate a method of securing the IUD  100  to the insertion tube  202  using the packaging system  400 . Referring to  FIG.  17   , the arms  106 ,  108  of the IUD  100  are substantially perpendicular to the shaft  104  of the IUD  100  and are positioned within the first receptacle  402 , with the arms  106 ,  108  spanning the width  408  of the first receptacle  402 , as discussed above. The rod  235  is positioned within the insertion tube  202  and circular end portion  232  (e.g., a ring) is positioned within the proximal depression  430  to prevent movement of the rod  235 . The insertion tube  202  is positioned within the slot  422  and is releasable coupled to the tray  406  by flanges  440 ,  442 ,  444 ,  446 . 
     Referring to  FIG.  18   , the end portion  232  of the rod  235  is rotated upwards to lift the end portion  232  out of the proximal depression  430  so that the rod  235  can be advanced distally through the insertion tube  202  towards the IUD  100  to apply a force to the end of the shaft  104  to move the arms  106 ,  108  from the first receptacle  402  into the second receptacle  404 . For example, the user can grasp the end portion  232  and push the rod  235  through the insertion tube  202  to push the arms  106 ,  108  of the IUD  100  distally into the second receptacle  404 . As the rod  235  pushes the arms  106 ,  108  into the second receptacle  404  along the floor  420 , the arms  106 ,  108  are pressed against the walls  414 ,  416 , therefore causing the arms  106 ,  108  to fold inwards towards the shaft  104 . 
     Referring to  FIG.  19   , the arms  106 ,  108  are pushed into a distal end of the second receptacle  404  to complete the folding of the arms  106 ,  108  into a collapsed state against the shaft  104  of the IUD  100 . Once the arms  106 ,  108  are folded against the shaft  104 , the insertion tube  202  is slid distally along the slot  422  and over proximal ends of the folded arms  106 ,  108 , as depicted in  FIG.  19   . 
     Referring to  FIG.  20   , once the insertion tube  202  is positioned over the folded arms  106 ,  108  to maintain the collapsed state of the arms  106 ,  108 , the IUD  100 , the insertion tube  202 , and the rod  235  can be removed from the tray  406  by lifting up on the insertion tube  202 , and the IUD  100  is ready for implantation in the uterus  102  of a patient. 
     The packaging system  200  has been described and illustrated with respect to a user pivoting the arms  236 ,  238  of the loading device  204  to fold the arms  106 ,  108  of the IUD  100  and sliding the insertion tube  202  over the folded arms  106 ,  108 . However, in some embodiments, a packaging system that is otherwise similar in construction and function to the packaging system  200  includes a loading device with a string that is used to pivot arms of the loading device to fold the arms  106 ,  108  of the IUD  100  and to secure the folded arms  106 ,  108  into an insertion tube  202 . 
     For example, as shown in  FIG.  21   , such a packaging system  500  is designed to house an IUD  100  along with an insertion tube  202  and a rod  235 . The packaging system  500  includes a tray (not shown) that is similar in structure and function to the tray  206 , a lid (not shown) that covers the tray, and a loading device  504 . The loading device  504  is substantially similar in construction and function to the loading device  204 , except that the loading device  504  further includes a string  502  (e.g., a suture, a wire, or another type of string) and an elongate body  520  that defines an opening  512  for allowing passage of the string  502 . Accordingly, in addition to the elongate body  520 , the loading device  504  further includes the arms  236 ,  238  and the receptacle  212 . 
     The string  502  is attached to the arms  236 ,  238  in a manner such that movement of the string  502  applies a force to the ends of the arms  236 ,  238 . For example, the string  502  may be secured to a top surface of the arms  236 ,  238  and pass over the ends the arms  236 ,  238 , or the string  502  may terminate at the ends of the arms  236 ,  238 . The string  502  also crosses over itself and passes through the opening  512  in the elongate body  220  to form a closed loop. 
     The packaging system  500  further includes a spring  506  that is positioned parallel to the insertion tube  202  and that is retained by the tray. A distal end of the spring  506  abuts the receptacle  212 , thereby applying a distally directed force to the loading device  504  that maintains the loading device  504  in place within the tray of the packaging system  500  while the string  502  is pulled by the user, as will be discussed in more detail below. Example materials from which the spring  506  can be made include steel, metal alloys, and plastic (e.g., polyetherimides (PEI) and thermoplastic elastomers (TPE)). 
       FIGS.  22 - 24    illustrate a method of securing the IUD  100  to the insertion tube  202  using the packaging system  500 . Referring to  FIG.  22   , the arms  106 ,  108  of the IUD  100  are coupled to the channels  244 ,  246  of the arms  236 ,  238  of the loading device  504 , and the insertion tube  202  is coupled to the receptacle  212  of the loading device  504 . A user can pull proximally on a looped end  510  of the string  502  away from the loading device  504  to pivot the arms  236 ,  238  of the loading device  504  inward towards the elongate body  520 , thereby also folding the arms  106 ,  108  of the IUD  100  inward towards the shaft  104  of the IUD  100 . 
     Referring to  FIG.  23   , a proximally directed force is continually applied to the looped end  510  of string  502  until the arms  236 ,  238  are substantially parallel to the elongate body  520  of the loading device  504  and the arms  106 ,  108  of the IUD  100  are folded against the shaft  104  of the IUD  100  in a collapsed configuration. 
     Referring to  FIG.  24   , once the proximally directed force on the looped end  510  of the string  502  overcomes the distally directed force exerted by the spring  506  on the loading device  504 , the loading device  504  moves proximally to compress the spring  506 . 
     The insertion tube  202  can be held in place by the user while the user continues to pull the string  502  such that the loading device  504  continues to move proximally, causing the ends of the folded arms  106 ,  108  to be drawn into the insertion tube  202  to secure the IUD  100  to the insertion tube  202 . 
     Once the folded arms  106 ,  108  are positioned within the insertion tube  202 , the user can release the string  502  to allow the arms  236 ,  238  to pivot back towards the initial configuration, thereby releasing the IUD  100  from the loading device  504 . The insertion tube  202  can then be lifted up from the tray. At this point, the IUD  100 , secured to the insertion tube  202 , is ready for placement in the uterus of a patient. 
     While the loading devices  204 ,  504  have been described and illustrated as including arms  236 ,  238  that form channels  244 ,  246  for receiving arms  106 ,  108  of an IUD  100 , in some embodiments, a loading device that is similar in construction and function to the loading devices  204 ,  504  can be formed without such channels. For example,  FIG.  25    illustrates such as loading device  604 . The loading device  604  includes an elongate body  620 , a receptacle  612 , and a pair of arms  636 ,  638 . 
     The receptacle  612  is sized and shaped to receive an insertion tube  202  and to restrict lateral movement of the insertion tube  202 . 
     The arms  636 ,  638  respectively extend from the elongate body  620  at flexible locations  654 ,  656 . The flexible locations  654 ,  656  are substantially similar in construction and function to the flexible locations  654 ,  656  such that arms  636 ,  638  are pivotable inward towards the elongate body  620  about the flexible locations  654 ,  656 , as described and illustrated with respect to the loading devices  204 ,  504 . 
     Each of the arms  636 ,  638  includes a flange  606 ,  608  positioned to engage with the end of a respective arm  106 ,  108  of the IUD  100  when the IUD  100  is positioned within the loading device  604 . For example, the distance between each of the flanges  606 ,  608  is less than the distance between the ends of the arms  106 ,  108  of the IUD  100  when the arms  106 ,  108  are substantially perpendicular to the shaft  104  of the IUD  100 . As such, when the arms  636 ,  638  are pivoted inward, the flanges  606 ,  608  push the arms  106 ,  108  of the IUD  100  inward to fold the arms  106 ,  108  toward the shaft  104 . 
       FIGS.  26  and  27    depict another example packaging system  700  that includes one or more receptacles formed to facilitate folding of the arms  106 ,  108  of an IUD  100  rather than a loading device  204  with pivotable arms  236 ,  238 . For example, the packaging system  700  houses the IUD  100  and is designed for securing the IUD  100  to an insertion tube  202 . The packaging system  700  includes a tray  706  defining multiple depressions formed in either of a main body  790  of the tray  706  or a loading aid  760  of the tray. In some embodiments, the main body  790  and the loading aid  760  are formed as two separate components that are assembled together during manufacture. In other embodiments, the tray  706  is provided as a single, unitary component that integrally defines the main body  790  and the loading aid  760 . The depressions include a distal depression  702 , a proximal depression  704 , and a slot  722  connecting the distal depression  702  and the proximal depression  704 . As depicted in  FIG.  27   , the slot  722  accommodates an insertion tube  202  and restricts lateral movement and angular movement of the insertion tube  202  outside the slot  722 . 
     As depicted in  FIGS.  26  and  27   , the slot  722  can include a gripping region  724  that is wider than the rest of the slot  722 . The gripping region  724  provides space for a user to grasp a cervical collar  128  that is slidably coupled to the insertion tube  202  and positioned within the gripping region  724  when the insertion tube  202  is positioned within the slot  722 . For example, when the insertion tube  202  is positioned in the slot  722 , a user can grasp the cervical collar  128  positioned in the gripping region  724  with his or her fingers and slide the cervical collar  128  proximally or distally relative to the insertion tube  202  until the cervical collar  128  corresponds to a depth measurement determined using a uterine sound. 
     For example, as can be seen in  FIGS.  26  and  27   , the tray  706  can also include markings  762  indicating positions to place the cervical collar  128  for corresponding to the depth measurement. For example, if a patient has a measured uterine depth of 8 cm, a user can grasp the cervical collar  128  positioned in the gripping region  724  of the slot  722  with his or her fingers and slide the cervical collar  128  proximally or distally relative to the insertion tube  202  until the cervical collar  128  is aligned with the 8 cm marking  762  on the tray  706 . 
     The tray  706  also includes flanges  740 ,  742 ,  744 ,  746  positioned adjacent to the slot  722  along the length of the slot  722 . The flanges  740 ,  742 ,  744 ,  746  narrow an axial opening of the slot  722  to help retain the insertion tube  202  in the slot  722  and prevent dislodgement of the insertion tube  202  from the tray  706  during transit of the system  700  prior to preparation of the IUD  100  for implantation. The insertion tube  202  can be detached from the tray  706  without damaging the insertion tube  202  or the tray  706 . 
     As depicted in  FIGS.  26  and  27   , the loading aid  760  is coupled to the distal portion  736  of the main body  790  of tray  706 . The loading aid  760  defines the distal depression  702  located adjacent the distal end of the slot  722 . The proximal end  703  of the distal depression  702  accommodates the arms  106 ,  108  of the IUD  100  in an initial configuration (e.g., a packaged state) in which the arms  106 ,  108  are substantially perpendicular to the shaft  104  of the IUD  100 , as depicted in  FIG.  27   . For example, a width of proximal end  703  of the distal depression  702  is larger than the distance between the end of the first arm  106  and the end of the second arm  108  when the arms  106 ,  108  are substantially perpendicular to the shaft  104  of the IUD  100 . Referring to  FIG.  30   , the proximal end  703  of the distal depression  702  has a width p. 
     As depicted in  FIGS.  26  and  27   , the loading aid  760  includes tapered walls  714 ,  716  that result in the distal end  705  of the distal depression  702  having a width that is narrower than the width of the proximal end  603  of the distal depression. The distal end  705  of the distal depression  702  has a minimum width sized to receive the arms  106 ,  108  of the IUD  100  in a collapsed or folded state (as depicted in  FIG.  19   ). For example, the distal depression  702  is formed as a generally triangular-shaped depression that narrows to the width near the distal end  729  of tray  706 . The tapered shape of distal depression  702  formed by the loading aid  760  causes the arms  106 ,  108  of the IUD  100  to be pushed inwards towards the shaft  104  of the IUD  100  through contact with walls  714 ,  716  of the loading aid  760  as the IUD  100  is pushed distally through the distal depression  702 . The tray  706  supports the IUD  100  as the IUD  100  is moved distally along the distal depression  702 . 
     The tray  706  further defines a proximal depression  704  located near the proximal end  728  of the tray  706 . As depicted in  FIG.  27   , the proximal depression  704  is sized to accommodate an inserter handle  900  that is used to control movement of the insertion tube  202 . For example, the inserter handle  900  includes a slider button  902  that can be used to control proximal and distal movement of the insertion tube  202  relative to the a rod  735  located within the insertion tube  202  and IUD  100  in order to capture and release the IUD  100  from the insertion tube  202 . The rod  735  is substantially similar in construction and function to the rod  235  of the packaging system  400 , except that the rod  734  includes a proximal end region that is formed for arrangement within the inserter handle  900  instead a proximal end region formed as the circular end  232 . 
     As can be seen in  FIG.  27   , the proximal depression  704  has a length that is longer than the inserter handle  900 , which allows the inserter handle  900  to be slid distally within the proximal depression  704  during the process of loading the IUD  100  into the insertion tube  202 . 
     The inserter handle  900  can be detached from the tray  706  without damaging the inserter handle  900  or the tray  706 . For example, the inserter handle  900  can be removed from the tray  706  once the IUD  100  is loaded into the insertion tube  202  and ready for insertion into the patient. 
     As depicted in  FIG.  26   , the system  700  can also include a protective cover  780  that can be placed over the inserter handle  900  to help prevent the inserter handle  900  from prematurely dislodging from the tray  706  and to help prevent movement of the slider button  902  during transportation, thereby protecting the inserter handle  900  from damage. The protective cover  780  can be removed from the tray  706  to expose the inserter handle  900  when a user is ready to load the IUD  100  into the insertion tube  202 . In some embodiments, the protective cover  780  is molded from a transparent plastic material. The protective cover  780  has a surface profile that is generally complementary to a surface profile formed by placement of the inserter handle  900  within the proximal depression  704  of the tray  706  such that the protective cover  780  can maintain the inserter handle  900  substantially in place. 
       FIGS.  27 - 29    illustrate a method of securing the IUD  100  to the insertion tube  202  using the packaging system  700 .  FIG.  27    illustrates a state of the IUD  100 , the insertion tube  202 , and the inserter handle  900  as initially packaged in the tray  706  upon opening of the packaging system  700  by a user. The arms  106 ,  108  of the IUD  100  are substantially perpendicular to the shaft  104  of the IUD  100  and are positioned within the distal depression  702 , with the arms  106 ,  108  spanning the width of the proximal end  703  of the distal depression  702 . The rod  735  is positioned within the insertion tube  202  and the slider button  902  of the inserter handle  900  is in a neutral position. The insertion tube  202  is positioned within the slot  722  and is releasably coupled to the tray  706  by flanges  740 ,  742 ,  744 ,  746 . 
     Referring to  FIG.  28   , the inserter handle  900  is advanced distally within the proximal depression  704  so that the rod  735  can be advanced distally through the insertion tube  202  towards the IUD  100  to apply a force to the end of the shaft  104  of the IUD  100  and move the IUD  100  distally within the distal depression  702 . As the IUD  100  is advanced distally within the distal depression  702 , the arms  106 ,  108  are pressed against the walls  714 ,  716  of the loading aid  760 , which causes the arms  106 ,  108  of the IUD  100  to fold inwards towards the shaft  104  of the IUD  100 . 
     Referring to  FIG.  29   , the handle  900  is advance distally within the proximal depression  704  until the IUD is positioned at the distal end  705  of the distal depression  702  and the arms  106 ,  108  of the IUD  100  are folded into a collapsed state against the shaft  104  of the IUD  100 . Once the arms  106 ,  108  are folded against the shaft  104 , the insertion tube  202  is slid distally along the slot  722  and over proximal ends of the folded arms  106 ,  108  of the IUD  100 , as depicted in  FIG.  29   . For example, the slider button  902  of the inserter handle  900  can be slid distally to a forward position (e.g., by a user&#39;s finger), which causes the insertion tube  202  to slide distally over the folded arms  106 ,  108  of the IUD. 
     Once the insertion tube  202  is positioned over the folded arms  106 ,  108  to maintain the collapsed state of the arms  106 ,  108 , the IUD  100 , the insertion tube  202 , the rod  735 , and the inserter handle  900  can be removed from the tray  706  by lifting up on the inserter handle  900 , and the IUD  100  is ready for implantation in the uterus  102  of a patient. 
     Once the IUD  100  is properly positioned within the uterus  102  of the patient (e.g., at the fundus  134  of the uterus  102 , as depicted in  FIG.  13   ), the slider button  902  of the inserter handle  900  can be drawn backwards (i.e., proximally) to a rear position to cause the insertion tube  202  to be withdrawn proximally and release the arms  106 ,  108  of the IUD  100  from the insertion tube  202 . The rod  735  inside of the insertion tube  202  is held steady by the inserter handle  900  while the insertion tube  202  is pulled proximally to release the arms  106 ,  108  of the IUD  100 . For example, the insertion tube  202  may be pulled proximally until the proximal end of the insertion tube  202  contacts the end portion  232  (shown in  FIG.  2   ) of the rod  735 . In some examples, the insertion tube  202  is pulled proximally by a distance of about 0.4 cm to about 0.6 cm (e.g., about 0.5 cm) to release the arms  106 ,  108  of the IUD  100 . 
     In some embodiments, the inserter handle  900  includes a locking mechanism (not shown) that secures the one or more threads  110  of the IUD  100  (shown in  FIG.  1   ) to the inserter handle  900  during loading of the IUD  100  into the insertion tube  2020  and implantation of the IUD  100  into the patient. For example, the locking mechanism of the inserter handle  900  remains closed over the threads  110  when the slider button  902  is in the neutral position or forward position (as shown in  FIGS.  27 - 29   ), and only releases the threads  110  when the slider button  902  is slid proximally into the rear position (e.g., during implantation of the IUD  100  in the uterus  102  as described above). In some embodiments, the slider button  902  is designed such that it cannot be withdrawn into the rear position until it has first been pushed distally into the forward position (as shown in  FIG.  29   ), which prevents premature release of the threads  110  of the IUD  100  from the inserter handle  900 . 
     After ensuring proper placement of the IUD  100  in the uterus  102 , the inserter handle  900  can be withdrawn proximally to remove the rod  735  and the insertion tube  202  from the cervical canal of the patient. In some examples, after removal of the insertion tube  202  from the patient, the one or more threads  110  coupled to the shaft  104  of the IUD  100  are trimmed. The threads of the IUD  100  may be trimmed so that a length of about 1.5 cm to about 2.0 cm (e.g., about 2.0 cm) of the one or more threads  110  extends out the cervical canal and into the vagina of the patient. 
       FIGS.  31  and  32    depict another example packaging system  800  that includes multiple receptacles formed to facilitate folding of the arms  106 ,  108  of an IUD  100 . For example, the packaging system  800  houses an IUD  100  and is designed for securing the IUD  100  to an insertion tube  202 . The packaging system  800  includes a tray  806  defining multiple depressions formed in either of a main body  890  of the tray  806  or a loading aid  860  of the tray. The depressions include a distal depression  802 , a proximal depression  804 , and a slot  822  connecting the distal depression  802  and the proximal depression  804 . 
     As depicted in  FIGS.  31  and  32   , the main body  890  of the tray  806  includes a first tray half  811  and a second tray half  813 . In some embodiments, the first tray half  811  and the loading aid  860  are formed as two separate components that are assembled together during manufacture. In other embodiments, the two portions are provided as a single, unitary, integral component. When fully assembled, as depicted in  FIG.  31   , the second tray half  813  is positioned over the top of a proximal portion  815  of the first tray half  811 . The second tray half  813  is slidable in the proximal and distal directions over the proximal portion  815  of the first tray half  811 , which enables distal movement of the inserter handle  900  to cause folding of the arms  106 ,  108  of the IUD  100  for loading into the insertion tube  202 . For example, as will be described in further detail herein, the second tray half  813  can be slid distally relative to the first tray half  811 , which causes the inserter handle  900  and rod  735  coupled to the inserter handle  900  to be advanced distally towards the IUD  100  to apply a force to the end of the shaft  104  of the IUD  100  and move the IUD distally within the distal depression  802 . As the IUD  100  is advanced distally within the distal depression  802 , the arms  106 ,  108  are pressed against the walls  814 ,  816  of a loading aid  860  defining the distal depression  802 , which causes the arms  106 ,  108  of the IUD  100  to fold inwards towards the shaft  104  of the IUD  100 . 
     As can be seen in  FIGS.  31  and  32   , the first tray half  811  includes two legs  817 ,  819  (e.g., elongate platforms) that slidably couple to two corresponding slots on the underside of the second tray half  813  by which the second tray half  813  can slide along the legs  817 ,  819 . In addition, the first tray half  811  includes two corresponding shoulders  821 ,  823  (e.g., abutment surfaces) that prevent distal movement of the second tray half  813  over the first tray half  811  beyond the shoulders  821 ,  823 . As can be seen in  FIGS.  31  and  32   , a height of the shoulders  821 ,  823  is elevated compared to that of the legs  817 ,  819  and to that of the second tray half  813 , which prevents further distal movement of the second tray half  813 . 
     Similar to distal depression  702  of tray  706 , the first tray half  811  includes a distal depression  802  defined by a loading aid  860  coupled to the distal portion  836  of the first tray half  811 . The proximal end  803  of the distal depression  802  accommodates the arms  106 ,  108  of the IUD  100  in an initial configuration (e.g., a packaged state) in which the arms  106 ,  108  are substantially perpendicular to the shaft  104  of the IUD  100 , as depicted in  FIG.  31   . As depicted in  FIGS.  31  and  32   , the loading aid  860  includes tapered walls  814 ,  816  that result in the distal end  805  of the distal depression  802  having a width that is narrower than the width of the proximal end  803  of the distal depression. The distal end  805  of the distal depression  802  has a width adjust large enough to receive the arms  106 ,  108  of the IUD  100  in a collapsed or folded state (as depicted in  FIG.  19   ). That is, the distal depression  802  is formed as a generally triangular-shaped depression that narrows distally towards distal end  829  of tray  806 . The shape of distal depression  802  formed by the loading aid  860  causes the arms  106 ,  108  of the IUD  100  to be pushed inwards towards the shaft  104  of the IUD  100  through contact with tapered walls  814 ,  816  of the loading aid  860  as the IUD  100  is pushed distally through the distal depression  802 . The tray  806  supports the IUD  100  as the IUD  100  is moved distally along the distal depression  802 . 
     Similar to proximal depression  704 , the second tray half  813  of tray  806  defines a proximal depression  804  located near the proximal end  828  of the tray  806 . As depicted in  FIG.  31   , the proximal depression  804  is sized to accommodate the inserter handle  900  and has a length that is slightly larger than the length of the inserter handle  900 , which prevents the inserter handle  900  from prematurely moving out of the tray  806  during transportation of the system  800  and loading of the IUD  100  into the insertion tube  202 . 
     As depicted in  FIG.  31   , the slot  822  accommodates an insertion tube  202  and restricts lateral movement and angular movement of the insertion tube  202  outside the slot  822 . As depicted in  FIGS.  31  and  32   , the slot  822  can include a gripping region  824  that is wider than the rest of the slot  722  (e.g., similar to gripping region  724  of tray  706  depicted in  FIGS.  26  and  27   ). The gripping region  824  provides space for a user to grasp a cervical collar  128  that is slidably coupled to of the insertion tube  202  and positioned within the gripping region  824  when the insertion tube  202  is positioned within the slot  822 . As can be seen in  FIGS.  31  and  32   , the first tray half  811  can include markings  862  indicating positions to position the cervical collar  128  according to a measured uterine depth, as discussed above with respect to the tray  706 . 
     A method of securing the IUD  100  to the insertion tube  202  using the packaging system  800  will be described with reference to  FIGS.  31  and  32   . Referring to  FIG.  31   , the arms  106 ,  108  of the IUD  100  are substantially perpendicular to the shaft  104  of the IUD  100  and are positioned within the distal depression  802 , with the arms  106 ,  108  spanning the width of the proximal end  803  of the distal depression  802  in an initial configuration of the packaging system  800 . The rod  735  is positioned within the insertion tube  202 , and the inserter handle  900  is positioned within the proximal depression  804 . The slider button  902  of the inserter handle  900  is in a neutral position. The insertion tube  202  is positioned within the slot  822 . 
     The second tray half  813  is slid distally along the leg  817 ,  819  of the first tray half  811  so that the inserter handle  900  and rod  735  coupled to the handle  900  are advanced distally towards the IUD  100 . For example, a user can hold the first tray half  811  still while sliding the second tray half  813  distally over the proximal portion  815  of the first tray half  811  using his or her fingers. As the rod  735  is advanced distally via distal movement of second tray half  813 , the rod  735  applies a force to the end of the shaft  104  of the IUD  100  to move the IUD  100  distally within the distal depression  802 . As the IUD  100  is advanced distally within the distal depression  802 , the arms  106 ,  108  are pressed against the loading aid  860 , which causes the arms  106 ,  108  of the IUD  100  to fold inwards towards the shaft  104  of the IUD  100 . 
     The second tray half  813  is slid distally along the legs  817 ,  819  of the first tray half  811  until the second tray half  813  abuts the shoulders  821 ,  823  of the first tray half  811 , which corresponds to the IUD  100  being positioned at the distal end  805  of the distal depression  802  and the arms  106 ,  108  of the IUD  100  being folded into a collapsed state against the shaft  104  of the IUD  100 . Once the arms  106 ,  108  are folded against the shaft  104 , the insertion tube  202  is slid distally along the slot  822  and over proximal ends of the folded arms  106 ,  108 . For example, the slider button  902  of the inserter handle  900  can be slid distally to a forward position, which causes the insertion tube  202  to slide distally over the folded arms  106 ,  108  of the IUD. 
     Once the insertion tube  202  is positioned over the folded arms  106 ,  108  of the IUD  100  to maintain the collapsed state of the arms  106 ,  108 , the IUD  100 , insertion tube  202 , rod  735 , and inserter handle  900  can be removed from the tray  806  by lifting up on the inserter handle  900 , and the IUD  100  can be implanted in the uterus  102  of a patient, as described above. 
     While the packaging systems  200 ,  500 ,  700 ,  800 ; the loading devices  204 ,  504 ,  604 ; and the trays  406 ,  706 ,  806  have been described and illustrated with respect to certain dimensions, sizes, shapes, arrangements, materials, and methods, in some embodiments, a packaging system, a loading device, or a tray that is otherwise substantially similar in construction and function to any of the packaging systems  200 ,  500 ,  700 ,  800 ; the loading devices  204 ,  504 ,  604 ; or the trays  406 ,  706 ,  806  may include one or more different dimensions, sizes, shapes, arrangements, and materials or may be utilized according to different methods. Accordingly, other embodiments are within the scope of the following claims.