Background
Cu-IUCD is the most common method for long-acting reversible contraception, but its high potential use is hampered by menstrual complications especially menorrhagia. So our work aimed to study the effect of Cu-IUCD on uterine artery blood flow through the assessment of uterine artery indices using transvaginal Doppler ultrasound (TVDU); and whether those potential findings could predict the risk of bleeding before insertion.

Method
This prospective observational study had performed on 100 women in the Department of Obstetrics and Gynecology, Zagazig University Hospitals who requested insertion of a Cu- IUD for contraception and who met the inclusion criteria. Pulsatility (PI) and resistance index (RI) of the uterine artery were measured just before, three, and six months post-insertion.

Results
Forty-eight women came complaining of menorrhagia and another 52 women were regularly menstruating. There was a substantial statistical variation concerning PI, and RI among women with IUD-induced menorrhagia and those with the normal menstrual cycle, while there was no difference as regards age, and abortion (P < 0.05). Uterine artery RI ≤ 0.809 and PI ≤ 2.078 was correlated with significant menstrual bleeding following insertion of IUCD.

Conclusion
Our results endorse our assumption that Vascular changes may represent a critical part in the occurrence of menorrhagia, so a study of TVDU of the uterine artery indices is a valuable means to predict the abnormal uterine bleeding for women pursuing the use of Cu-IUCD and lead to the proper choice for contraception and decrease the complications as possible.