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Abstract The most important copper intrauterine device-IUD related side effects are uterine bleeding and / or menstrual pain (Escudero et al., 1999).The uterine artery and ovarian blood flow were not altered significantly after copper{u2013} medicated IUD insertion, as evidenced by resistance index (RI) and pulsatility index (PI) (Shen et al., 2008). Color Doppler studies (Pirhonen and Pulkkinen, 1995) showed an increase blood flow resistance in uterus of patients with primary dysmenorrhea. Other studies showed no change in uterine artery PI during menstruation after IUD insertion but there was an increased menstrual pain (Jarvela et al., 2000 and Momtaz et al., 1994).This may be sign of uterine microvascularity malfunction that make these patients more prone to IUD-related side effects.Frajndich et al. (2000), also studied the effects of IUD on the pelvic blood flow and observed an increased risk of menorrhagia in patients with elevated PI. They observed also that women who developed menorrhagia had significantly lower PI and RI of the uterine arteries when compared with control patients. They concluded that when PI of uterine arteries is {u02C3} 2.00, women might be at a higher risk for development of IUD- induced bleeding. However, Momtaz et al. (1994), found that, women who has low PI {u02C2} 2.00 she might develop menorrhagia after IUCD insertion |