Abstract
Unintended pregnancy following placement of an intrauterine device is a rare occurrence; however, it entails increased obstetrical risks if the device remains within the uterine cavity. This already challenging condition may be exacerbated by additional gynecological conditions, which would be of little or moderate risk on their own. In this report, we present such an exceedingly rare case, namely that of a 42-year-old woman who presented with unintended pregnancy, the presence of an IUD in the endometrial cavity, and a large (>10 cm) uterine fibroid. This report highlights the importance of proper patient counseling on the potential failure of IUDs and the need for frequent follow-up assessment of its placement, along with general gynecological assessment, in order to avoid the occurrence of complex gynecological pathology.