Comparative evaluation of medicated and non-medicated IUDs of the same size and shape.
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The increase in menstrual blood loss (MBL) caused by IUDs may result in iron deficiency anemia. 60 women completing 2 years of Cu-IUD use were investigated for this risk, using hemoglobin concentration serum iron indices. No significant differences were found compared to a control group of women requesting interval Cu-IUD insertion. A decrease in the MBL increment with time following insertion, self-selection of the study population, and increased dietary iron absorption are suggested explanations for these results. 15.4% of patients suffered from iron deficiency anemia. Measurement of serum ferritin is advocated to identify these women for treatment, in order to enhance maternal health.
The Massouras Duck's Foot (MDF) IUD and the Butterfly IUD have been clinically evaluated. The MDF, which is Y-shaped, has 2 or 3 horizontal arms on a vertical stem and 2 triangular wings, in between the 'V'. When inserted after curettage, it prevents intrauterine or intracervical adhesions. The fan-shaped Butterfly IUD has 2 overlapping wings, thereby facilitating adjustment of the IUD to variable uterine cavities. Its wing span occupies the entire uterine cavity when inserted according to the instructions. Both IUDs are made of polyethylene plastic with barium sulfate. Several substitutions for barium sulfate are suggested, e.g., copper, silver, hormones, biodegradable polymers. The high antifertility action of these IUDs is due primarily to their occupancy of the entire uterine cavity.
35 women of proven fertility who were scheduled for surgical sterilization by salpingectomy were selected for this study; 15 control patients, 10 patients using the Multiload (ML) Cu 250 IUD, and 10 fitted with nonmedicated IUDs. Increased copper concentration did not affect sperm receptivity by the cervical mucus, but did significantly affect sperm motility and survival. Nonmedicated IUDs did not interfere with sperm transport in the oviduct. ML Cu IUDs inhibited sperm transport in the oviduct. The effects of the ML Cu IUD on sperm migration were more evident at the tubal level than at the cervical level.
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A randomized study was conducted to compare the clinical performance of the ML Cu 25-standard and the ML Cu 250-short devices. 375 insertions were performed postmenstrually to mainly parous women 16-43 years of age. Over 90% of the women in both IUD groups had uterine sound lengths from 7-9 cm. The rates are based on the total of 4273 woman months of use. The lost-to-follow-up rates at 12 months were 6.7 and 4.6% for standard and short ML series, respectively. The ML Cu 250-standard had a lower pregnancy rate and a lower removal rate for bleeding and/or pain, but a higher expulsion rate that the short model. However, these differences were not statistically significant. The shortening of the vertical arm of the Multiload device has no remarkable effect on its clinical performance.
The nylon T IUD is identical to the copper T 200 except for the composition of nylon/copper. A study conducted at the Family Planning Institute in Ljubljana, Yugoslavia compared the nylon T with the copper T. Devices were randomly administered to women who had not been pregnant during the month prior to insertion. The pregnancy rate for the nylon T group was 13.0 at 12 months, significantly higher (Por= 0.01) than the rate of 0.0 for the copper T group. Effectiveness of copper devices is related to the copper itself, rather than being an effect of the increased surface area alone.
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