Chances are 1 in 1000 with peforation at insertion. However, my IUD was checked three times in the 6 weeks after I had it placed and it was in place. It was checked by three different doctors! Chance of perforation during expulsion is very very very low and very rare. Most women that expel have never had a baby or a full term pregnancy, etc. The only thing I had was never a full term pregnancy, BUT I have had three babies vaginally! Like I said, my ob said this was only the second time he saw this in his career. I just keep making myself memorable. I went back to work today due to no leave. At least I know why I have felt so sick and been running fevers for a month now. It honestly feels better out than it did in. I figure it expelled about a month ago. That's when I started feeling sick. The huge antibiotics I am on suck though. They are like horsepills. I know I need them to clear things up.