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PubMed1984

Copper intravas device (IVD) and male contraception.

An alternative method of male contraception is crucial at this stage of increasing population in the developing world. A non-obstructive, non-hormonal, reversible method of male contraception would find acceptance in oriental communities. Our experience with copper IVD in small animals has been encouraging. We present here an extension of the use of the copper IVD in the rhesus monkey. Treated male rhesus ejaculate showed fifteen-to thirty-five-fold increase in copper levels up to 10 months after insertion of Cu IVD . Semen analysis showed an increase of dead sperm (23.0% - 52.3%; control 4.5% - 14.0%) and decrease in percentage of motile sperm (10-30%; control 70-80%). Fertility studies using treated male rhesus of proven fertility from the breeding colony mated with cycling females of proven fertility showed highly significant reduction of fertility up to 13 months (P less than 0.001). Reduction in fertility of the treated rhesus was also significant up to a period of 23 months (P less than 0.01). A reversal of contraceptive effect and increase in sperm count and motility is observed after 13 months post-treatment. Studies are required to achieve an increase in the effective life span of the IVD .

Animals↗
PubMed1988

[Epidemiologic aspects of extrauterine pregnancy].

Looking over the last twenty years, the increase in the numbers of ectopic pregnancies has become an important health issue. It is necessary to find out the principal causes for the rise if preventive action is to be taken. Different publications have widely different views about the incidence of the condition and how the increase came about. This variation is due to the diversity of the places and of the different populations that have been studied (age, the way the populations were recruited) as well as the frequencies that have been calculated (according to the number of pregnancies, according to the number of deliveries or according to the number of women of reproductive age in a population). All the same, the trend can be noted. These are: the doubling or tripling in the last two decades of the incidence in industrialised countries. The results of certain epidemiological studies undertaken to seek out the risk factors (mainly based on case histories) have to be interpreted carefully because of the differences in methodology and particularly in the choice of control groups (there seems to be some failure to take into account confounding factors). The chief of the risk factors for extra-uterine pregnancy which are now considered important are the increase in sexually transmitted diseases and in particular in Chlamydia trachomatis. The role played by tubal sterilisation and by some contraceptive measures such as intra-uterine contraceptive device and the progestational mini-pill in the causation of extra-uterine pregnancy can be explained by the fact that these methods are better at preventing intra-uterine pregnancy than extra-uterine pregnancy, although they to diminish the risk of these as well. Furthermore, spontaneous abortions, abdominal surgery and, above all, terminations of pregnancy which had been said to be conductive to the causation of extra-uterine pregnancies, seem to do this by the fact that they are associated with pelvic inflammatory disease. Finally, the role of in vitro fertilisation, and of vaginal irrigation, as well as of nicotine, should be sought out when further studies are carried out.

Adolescent↗
PubMed1985

The cervical cap as a contraceptive alternative.

A recent resurgence in the United States of popular interest in the cervical cap has prompted reexamination of its safety and effectiveness as a contraceptive device. Despite widespread use in Europe, few studies are available for evaluation of this non-hormonal, non-invasive barrier method of contraception. The U.S. Food and Drug Administration classified the cap as a "significant risk device" and has limited dispensing of the cap to providers with Investigational Device Exemptions. Use and fitting of the cervical cap are described.

Contraceptive Devices, Female↗
PubMedDate not supplied

[Personal experience with the extraction of "lost" intrauterine devices by the Soonawalla method].

From 1981 to 1983, 3660 intrauterine contraceptive devices were taken away, in 278 cases by the modified extractor after Soonawalla, because the short tread of the device was broken or drawn into the uterus. The most frequent indication for the removal of the device was irregular bleeding. Prior to extraction, X-ray and ultrasound were used to determine the position of the device in the uterus.

Female↗
PubMed1977

The benefits and risks of IUD use.

Next to combination oral contraceptives (OCs), intrauterine contraceptive devices (IUDs) are the most effect form of contraception available. IUDs require only one-time motivation, cause no systemic metabolic effects, and do not depend on continued action of the user for effectiveness. Risks, side effects and complications of this method, including expulsion, perforation pain, bleeding and infection, are reviewed.

Abortion, Septic↗
PubMedDate not supplied

Missing IUD strings: diagnosis and management at Ilorin.

BACKGROUND: Intrauterine contraceptive device (IUD) is a widely accepted method of contraception. One of the complications reported with IUD use is missing IUD. METHODS: This retrospective study was carried out on a total of forty-two women who had missing IUDs over a three-year period (January 1992-December 1994). Socio-demographic data, type of previous contraception, timing of insertion, service provider of IUD, diagnostic and management methods of these cases were reviewed. Epiinfo statistical software package was used for analysis and the level of significance was at p<0.001. RESULTS: The total missing IUDs for the years under review accounted for 0.25% of total IUD continuous users or 0.89% of total new IUD acceptors. There was a slight decline over the study period in the percentage of missing IUDs. Majority (85.71%) presented more than 6 months postpartum for insertion while insertions during menses was common (71.43%). Expulsions of IUDs was recorded in 21 (50%) clients. Pelvic examination with uterine sound and abdominopelvic ultrasound were the diagnostic methods commonly used. Trainees at the family planning unit inserted most of the missing IUDs while most clients (71.43%) missed their IUDs especially within the first three months of use. Retrieval loop alone (64.29%) and with dilatation (11.91%) and uterine sounding alone (16.67%) were commonly employed in the management of missing IUDs. About a third had no associated complications. CONCLUSIONS: Prevalence of missing IUDs is low in this centre occurring mostly within 3 months of insertion. Good selection of women using IUDs will result in less reported cases of missing IUDs. Counselling will motivate the IUD user to present early when any complication arise. The trainees need closer supervision and should be taught appropriate insertion techniques.

Abdomen↗
PubMedDate not supplied

Reproductive health: an international perspective.

The twentieth century began with approximately 1.6 billion human beings in the world and, with an increase of 96 million people per year, will end with over 6 billion people. Unless this trend is directly confronted by the world governments and their citizens, there will be nearly 8 billion by 2025 and over 11 billion by 2050. Thus, reproductive health is and will remain an issue of critical importance for all countries to realize and study. Part of this trend is because of the many pregnancies which occur in adolescents around the world. A number of issues have developed this century contributing to the many pregnant teenagers. For example, India has one of the world's largest populations of teenagers--over 23 million, representing over 26% of the total in the world. Effective methods for contraception and sexually transmitted diseases prevention are available, but not to all sexually active humans. However, many barriers to effective contraception exist around the globe. This article discusses some of them and also reviews use of contraceptive methods in various countries. These include oral contraceptives, emergency contraceptives, injectable and implantable contraceptives, intrauterine devices, barrier contraceptives and others. Reproductive health remains a critical, universal issue for all humans in the world. We all must examine the many pitfalls to controlling the world's populations, including lack of sex education, limited access to effective contraceptives, and others. We cannot afford to let the population continue unchecked. Effective strategies are needed at this time; otherwise, the population will continue to run out of control, negatively damaging the world for the coming generations. There is need to leave a positive, and not negative legacy for the next generation.

Adolescent↗
PubMed2004

Coil or intrauterine device? Patient preferences for contraceptive terminology.

OBJECTIVE: To discover what terminology women prefer to use when referring to contraceptive methods and to investigate the understanding of and ideas associated with contraceptive names. DESIGN: A self-administered questionnaire was answered by 191 new patients at family planning clinics (FPCs). Women were asked if they understood the terms used by the fpa (Family Planning Association), if they knew of any alternatives and, if so, which they preferred. SETTING: Selected FPCs across the city of Manchester. RESULTS: Patients preferred to use familiar terms, e.g. pill, mini-pill, coil and morning-after pill. There was no difference in preference when the results were compared by age or educational level. A greater proportion of non-Caucasians than Caucasians preferred the precise (fpa) terms. Although precise terms were not widely known or understood, when used they were associated with more information than were the familiar terms. CONCLUSION: All FPC staff should evaluate the language used by individual patients and, where appropriate, introduce precise terminology to help patients to make informed, appropriate choices.

Adolescent↗
PubMed1954

[New cervical cap].

Explore the source record for details and available documents.

Contraceptive Devices↗
PubMed1978

[An atraumatic instrument for the removal of the lost string intra-uterine device (author's transl)].

A less common complication of intra-uterine device contraception is the lost string. Since the intra-uterine devices are more used the problem of the search for lost string intra-uterine devices has increased. An intra-uterine device forceps with a diameter of 2.5 mm. is presented. The instrument can easily be used in office practice. Removal of the device under general anaesthesia after dilation of the cervix with a large instrument can best be avoided.

Female↗
PubMed1967

Intrauterine devices: effects on ultrastructure of human endometrium.

The human endometrium, studied with the electron microscope, undergoes asynchronous and premature cyclic development in response to inin uterine contraceptive devices. Typical nucleolar channel systems and other cellular characteristics of the normal secretory phase appear before ovulation, and decidualization occurs several days prematurely. Disturbance of the synchrony of ovular and endometrial development may be a mechanism of contraceptive action of these devices.

Cell Nucleolus↗
PubMed1997

Colocolic fistula caused by a previously inserted intrauterine device. Case report.

Uterine perforation remains the most serious complication of the intrauterine contraceptive device (IUD). It is more common in the puerperium, usually occurring at the time of insertion of a new device. Perforation may, however, also occur in the puerperium if a pre-existing device is not removed in early pregnancy or extruded at the time of delivery. The case is presented of a 30-year-old woman who became pregnant for the third time following insertion of an IUD in the puerperium of her second pregnancy. An uneventful pregnancy and delivery followed. Failure to detect the IUD at the time of delivery led to laparoscopy and laparotomy to locate the device. A colotomy was necessary to retrieve the device, which had formed a colocolic fistula. It is concluded that the puerperium remains the time of greatest risk of uterine perforation by an IUD. Although most occur at the time of insertion, this complication can also occur with a previously inserted device. Severe intra-abdominal complications may ensue if the device is not localized and removed. Laparotomy is justified if the laparoscopic removal is unsuccessful. A high degree of suspicion is necessary if serious consequences are to be avoided.

Adult↗
PubMed2005

Five years' experience with a small intracervical/intrauterine levonorgestrel-releasing device.

OBJECTIVE: A randomized study was performed to compare the efficacy, safety and acceptability of a new model of an intracervical/intrauterine contraceptive device (ICD) releasing 20 microg of levonorgestrel (LNG) per day. METHODS: The LNG-ICD was inserted in Group I into the cervical canal and in Group II into the uterine cavity. Group I included 151 women (age, 18-43 years) whereas Group II included 147 (age, 19-43 years). The number of nulliparous women was 145. RESULTS: The 5-year results are presented here. The results showed a total continuation rate of 50%; the continuation rate in the cervical group and that in the uterine group were 53.6% and 46.3%, respectively--the difference being statistically insignificant (p=.3593). The main reason for termination was a wish for pregnancy, which is explained by the relatively young age and degree of nulliparity of the study population. During the first year, two pregnancies occurred in both groups. Two of these were ectopic, one in each group. The other two occurred after unnoticed expulsions. Thereafter, no pregnancies occurred. The cumulative gross rate for pregnancy was 1.3 and the Pearl index at 5 years was 0.425. The total expulsion rate was relatively high (11.1%). Expulsions occurring during the first few months of the first year were related to insertion. Removals because of bleeding and because of amenorrhea were low, the combined gross rate being 5.7 and the Pearl rate 1.8 at 5 years. Also, the gross rate of infection was low (0.7). The continuation was high in spite of a high rate of removals for planning pregnancy (15.4). CONCLUSIONS: The method is safe and effective. There were only minor differences between the groups. There were no perforations and the incidence of infection was low. The device can also be used by young nulliparous women.

Adolescent↗
PubMed1994

[Pseudo-sulfur granules (pseudo-actinomycotic granules) in intrauterine device patients].

In 14 tissues from uterine curettages from women with intrauterine contraceptive devices (IUD) we found structures were discovered, which could easily be mistaken for actinomycotic sulphur granules. These were characterised by radial filamentous eosinophilic structures with peripheral club-like swellings. The dissimilarities to a true sulphur granule are evident with Gram staining which shows single filaments substantially wider than those of the true actinomycotic granules. Until now the nature of the described structures is not clear. They are possibly deposits on the copper thread of the IUD.

Actinomyces↗
PubMed1999

Barriers to the use of IUDs as emergency contraception.

The intrauterine contraceptive device (IUD) is a very effective form of emergency contraception (EC). This author hypothesised that IUDs are an underused method and determined to evaluate potential barriers to IUD use. A postal survey of 100 family planning doctors and 100 general practitioners was conducted in Trent Region during March 1998 with a 70 per cent response rate. Lack of time was the most important factor that influenced doctor's decisions not to offer IUDs to the majority of women requesting emergency contraception. Most doctors registered concern about the risk of pelvic inflammatory disease. Misconceptions and a lack of accurate information contributed to participants reluctance to discuss IUDs as emergency contraception. Lack of time in consultations is a well-recognised issue in general practice. The risk of sexually transmitted infections is a nationwide concern, but is difficult to address without accurate data on the prevalence of the most common pathogens. Considerable effort would be required to increase doctors' knowledge and willingness to offer IUDs routinely to women requesting emergency contraception.

Adult↗