Main disadvantages of intrauterine contraceptive devices is that

Options

A. the devices are permanently placed in uterus and cannot be removed even if couple want to have children
B. the device has to be inserted by physician in the uterus through vagina
C. the devices are expelled out without the knowledge of the wearers
D. both (a) and (c)

Explanation

### Step-by-Step Solution:

1. **Understanding Intrauterine Contraceptive Devices (IUCDs)**:
- IUCDs are birth control devices that are inserted into the uterus to prevent pregnancy. They are typically inserted by a physician.

2. **Evaluating the Options**:
- The question asks for the main disadvantages of IUCDs. We will analyze each option provided.

3. **Option A: Devices are permanently placed in the uterus and can't be removed even if the couple wants to have children**:
- This statement is incorrect. IUCDs are not permanently placed; they can be removed by a physician whenever the couple decides they want to conceive. Therefore, this is not a disadvantage.

4. **Option B: Devices have to be inserted by a physician in the uterus through the vagina**:
- While this statement is true, it is not necessarily a disadvantage. The insertion is a one-time procedure, and it is performed by a qualified physician, which ensures safety and proper placement. Thus, this is not a significant disadvantage.

5. **Option C: Devices are expelled out without the knowledge of the wearer**:
- This is a valid concern. Sometimes, IUCDs can be expelled from the uterus without the wearer being aware of it. If this happens, the woman may unknowingly be at risk of pregnancy, leading to unwanted pregnancies. This is indeed a major disadvantage of IUCDs.

6. **Option D: Both A and C**:
- Since Option A is incorrect and Option C is correct, this option is also incorrect.

7. **Conclusion**:
- The main disadvantage of intrauterine contraceptive devices is that they can be expelled out without the knowledge of the wearer (Option C).

### Final Answer:
The main disadvantage of intrauterine contraceptive devices is that **devices are expelled out without the knowledge of the wearer**.

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