But my Pregnancy Test Was Negative!

An AD 35yo G3P3 African American female arrived to the office for placement of the Mirena IUD. She'd been on OCPs for the past two years for managment of dysmenorrhea and decided she wanted to have some time off of the pills to "let my hormones get normal" and "to get ready to maybe have one more baby before I'm too old." She felt that an IUD offered a quicker pause for the cause in her fertility plan since the last time she was on OCP it took her "a year" to get pregnant. Although she was advised to continue her OCP until successful placement of the IUD or at least protected intercourse until placement, she'd stopped her OCPs in early May and had one short, scant period in mid May.
She'd obtained her negative Hcg test the afternoon prior to the visit and was excited to have the IUD placed. However, as we reviewed her history of recent coital encounters, we learned that she'd had unprotected intercourse for the past three days.
We informed her that she was no longer a candidate for IUD placement in the event that she was actually already in the process of conceiving. To which she responded, "But my pregnancy test was negative and I had my period last month."
She overassumed the use of OCPs for mere management of dysmenorrhea and somehow failed to realize its additional "anti-contraceptive" benefits! So this is someone of a GYN/OB combo I recon. But the take home is...ensure that clients understand both the intent of the prescription of OCPs for a specific GYN issue but also ensure that they thoroughly understand the full range of physiologic consequences especially it's influence on fertility while consuming.