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Serious side effects of Mirena that have been reported include: depression pelvic infection, such as pelvic inflammatory disease (PID) ovarian cysts risk of internal injury, such as perforation (puncture) of the uterus sepsis (a serious condition caused by your bodys reaction to an infection) IUD expulsion (falling out of the uterus), which may cause loss of effectiveness risk of serious pregnancy complications if pregnancy occurs while using Mirena* severe allergic reaction * To learn more about this risk, see the Pregnancy and breastfeeding section in What should be considered before using Mirena? below