IUD expulsion can occur in 2-10% of people in the first year after insertion. Expulsion can be more likely for people who:     **1.** Haven’t been pregnant **2.** Are younger than 20 years  **3.** Have a history of very heavy or very painful periods (though be mindful that these are reasons doctors recommend the hormonal IUD in the first place…)  **4.** Had the IUD put in right after giving birth or having a 2nd trimester abortion.  A partial expulsion __may__ mean that the IUD was not quite in the right position: it may have been too low in the uterus and just worked its way out. This could be something that happened around the time of insertion, or may be related to uterine characteristics, such as size, angle, or presence of conditions like fibroids that can cause irregular shape. For people who have an IUD expulsion, the chance of expelling a 2nd IUD may be higher—in the 20% range (up to 30% in some studies).      If you want a second IUD after the first one came out, consider asking your health care provider about inserting the 2nd IUD while using an ultrasound machine to make sure the IUD is inserted all the way to the fundus.