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PubMed1983

Five years' experience of intrauterine contraception with the Nova-T and the Copper-T-200.

A randomized study was performed for the comparison of two copper-releasing intrauterine contraceptive devices (IUDs), the Nova-T and the Copper-T-200, simultaneously in Denmark, Finland, and Sweden. Five years' experience demonstrated that Nova-T users had a significantly lower pregnancy rate than Copper-T-200 users. The Pearl index over 5 years was 0.8 for Nova-T users and 2.0 for Copper-T users. The performance and tolerance of the Nova-T were less affected by parity and age than was the performance of the Copper-T. Infections were treated by removal of the device and with antibiotics. The cumulative rate of removals because of infections and suspected infections was below 5 with both devices over 5 years. The copper wire in the Nova-T has a silver core which prevents corrosion-induced fragmentation of the wire. Hence, the effective lifetime of this device is more than 5 years. The results indicate that the Nova-T, which is easy to insert and remove and is associated with a low pregnancy rate and a low medical termination rate, is a real improvement over other IUDs.

Adult↗
PubMed1975

Studies of blood glucose and plasma insulin in "normal" women using mechanical contraception for 6 months.

A prospective study of carbohydrate metabolism was done with 56 "normal" women who were 4 to 11 weeks post partum. Each had a 3 hour oral glucose tolerance test performed before and after 6 months of using an intrauterine contraceptive device (IUCD). The results showed only slight changes in blood glucose and plasma insulin levels between the two tests. There were elevations of the fasting and 0.5 hour glucose values and the 2 hour plasma insulin value at the 6 month test. These data provide a further understanding of the changing metabolic parameters associated with pregnancy and they also give the "control" baseline information for comparison with other postpartum studies on the metabolic effects of contraceptive steriods.

Adult↗
PubMed1998

The effect of diclofenac on uterine artery blood flow resistance during menstruation in patients with and without a copper intrauterine device.

The aim was to evaluate the effect of diclofenac on uterine artery blood flow resistance during the first day of menstruation. A total of 28 regularly menstruating women were examined longitudinally with and without a copper intrauterine contraceptive device (IUD) by transvaginal colour Doppler ultrasonography. The uterine artery pulsatility index (PI) was first measured, after which 50 mg of diclofenac was infused i.v. After 15 min the PI was measured again. The patients evaluated their menstrual pain with a scoring system before and after the diclofenac infusion. The mean PI (SD) during menstruation was significantly lower with the IUD [2.13 (0.43)] than without [2.39 (0.62)], P = 0.05. The mean PI in nine patients who experienced advanced menstrual pain was also lower in the presence of the IUD [2.16 (0.42)] than without it [2.83 (0.78); P < 0.05]. Diclofenac was effective in revealing menstrual pain both with and without the IUD, and reduced the PI in the absence of an IUD [pre-treatment 2.39 (0.62) versus post-treatment 2.12 (0.45); P < 0.001], but had no effect when the IUD was present [pre-treatment 2.13 (0.43) versus post-treatment 2.10 (0.41)]. The results indicate that by inhibiting prostaglandin synthesis one can reduce the resistance to blood flow in the uterine arteries during menstruation. This does not hold true when an IUD is present, however, suggesting that the device might induce the production of vasoactive agents other than prostaglandins in the surrounding tissue.

Adult↗
PubMed1986

New Zealand contraception and health study: design and preliminary report. New Zealand Contraception and Health Study Group.

The New Zealand contraception and health study is investigating the potential health risks associated with oral contraceptives, intrauterine contraceptive devices and injectable medroxy-progesterone acetate. This prospective observational study, begun as a pilot study in 1980, will record for at least six years the health of approximately 7500 women divided into three groups of equal size according to contraceptive method at entry. A major objective is to compare the incidence of dysplasia, carcinoma in situ and invasive carcinoma of the cervix in each group. This paper describes the design of the study and reports its progress.

Adult↗
PubMed1999

Performance of the frameless IUD (Flexigard prototype inserter) and the TCu380A after six years as part of a WHO multicenter randomized comparative clinical trial in parous women.

The clinical performance of the new Frameless IUD was compared with the TCu380A, the most widely used copper IUD in the world today. Insertions of the Frameless IUD were conducted with a prototype inserter (Flexigard). We report on the 6-year results from a randomized comparative clinical trial conducted at the Shanghai Institute of Planned Parenthood Research, as part of an international multicenter WHO clinical trial, involving 200 women, respectively recruited for use of each device. The cumulative 6-year pregnancy rates were 0.0 per 100 women for the Frameless IUD and 3.3 for TCu380A. Termination due to partial expulsion was significantly less for the Frameless IUD as compared with TCu380A (0.0 and 4.3 per hundred women, respectively). Complete expulsion, bleeding, pain, bleeding and pain and other medical reasons for termination did not differ significantly between the two devices. The net cumulative continuation rates at six years per 100 women were 80.8 for TCu380A, and 83.0 for the Frameless IUD. Both Frameless IUD and TCu380A are highly effective, safe and acceptable contraceptive devices, because of low pregnancy rates (per 100 women), and low termination rates due to expulsion, pain, bleeding, and bleeding and pain. Due to its anchoring, the Frameless IUD is significantly more effective than the TCu380A IUD as regards proper retention of the IUD in the uterine cavity. This may also explain its lower failure rate.

Adult↗
PubMed2005

Levonorgestrel hormone releasing intrauterine system (Mirena) as a contraceptive in egg donors: case report.

We report the safe use of levonorgestrel hormone releasing intra uterine system (Mirena) as a contraceptive in egg donors during a treatment cycle. In the first case report, a 29-year-old egg donor using the Mirena coil for contraception and two egg recipients, aged 41 years and 32 years respectively underwent standard IVF treatment, oocyte retrieval in the egg donor and in vitro fertilization followed by embryo transfer in the recipient. The outcome of IVF cycle using donor eggs was satisfactory with successful pregnancy in the egg recipient. The second case involved a 34-year-old egg donor using the Mirena coil and a 44-year-old recipient. Our findings suggest that egg donors can safely use the (Mirena) as a contraceptive device during treatment, without compromising follicular development and oocyte quality.

Adult↗
PubMed2004

[Double bladder lithiasis from an intrauterine device. Report one case].

OBJECTIVES: To report a new case of an intrauterine device causing bladder lithiasis, because of its rarity as a complication of the intrauterine device contraceptive method. METHODS/RESULTS: 27-year-old female patient admitted in the urology department of the "Hospital Medico-quirurgico 10 de Octubre" who having an intrauterine device was pregnant, underwent a caesarean section, and a new intrauterine device implant, and a few months later presented with lower urinary tract infectious syndrome, being diagnosed of double bladder lithiasis secondary to intrauterine device migration, for which cystolithotomy was performed. CONCLUSIONS: We performed a short review of the bladder foreign bodies reported in the literature, and present this case which is very infrequent because of the finding of 2 stones in the bladder and an intrauterine device inside one of them. The intrauterine device was detected after crushing one of the calculi, 2 cm in size. It seems that first intrauterine device had migrated through the uterine wall into the bladder, creating a calcareous concretion around.

Adult↗
PubMed1982

Tissue concentrations of levonorgestrel in women using a levonorgestrel-releasing IUD.

Thirteen women who were scheduled for hysterectomy volunteered for the study. Nine women had a levonorgestrel-releasing intrauterine contraceptive device inserted between 36 and 49 days prior to surgery and four women were on oral levonorgestrel treatment for 7 days prior to surgery. After the surgical removal of the uterus, samples of endometrial, myometrial, fallopian tube and fat tissue were obtained. Methods for measuring tissue concentrations of levonorgestrel were developed and the uptake of levonorgestrel by fat tissue in vitro was studied. The concentrations of levonorgestrel in myometrial, fallopian tube and fat tissue were all of the same order, of between 1 and 5 ng/g of wet weight of tissue, in both the intrauterine device group and the orally treated group. In the endometrium the levonorgestrel concentrations were many-fold higher in the intrauterine device group. The in vitro experiments showed a rapid uptake of levonorgestrel and an unsaturability of the fat tissue by the steroid at the concentrations used. The fat tissue concentrations of levonorgestrel correlated with the plasma concentrations.

Adipose Tissue↗
PubMed1985

Contraception for the adolescent.

The primary care physician is in an excellent position to counsel adolescents about contraception. However, an adequate understanding of the biologic and psychosocial development of this particular age-group is imperative. In addition, communication skills are necessary to advise adolescents on use of contraceptives. The goal in counseling the adolescent about sexuality is to instill a sense of sexual responsibility and to provide individualized instruction in selecting the appropriate birth control method. General factors to remember in selecting the proper method include motivation, moral-ethical responsibility, frequency of intercourse, side effects of the various contraceptive methods, and patient's preference.

Adolescent↗
PubMed1987

Contraception in general practice analyzed by a computerized medical record.

By a computerized medical record 174 patients who consulted a general practitioner regularly for contraceptive advice through 51 months were selected. There were 67 patients aged 25.9 +/- 4.0 (mean +/- SD), using Lynestrenol 0.75 mg and etinyloestradiol 375 micrograms or Levonorgestrel 0.150 mg and etinyloestradiol 30 micrograms. Eleven patients aged 27.2 +/- 5.3 using Noretisteron 0.3 mg and 96 patients aged 33.3 +/- 6.0 using intrauterine contraceptive device (IUCD). As judged by the Pearl index, the Pill-users unwantedly and unexpectedly became pregnant more often than IUCD-users. Acute salpingitis was encountered in six Pill-users, and in one with IUCD. There was more often purulent vaginal discharge and metrorrhagia in the Pill-group, but the hemoglobin values were similar. The importance of these findings remain to be established, but they suggest that the IUCD may be more reliable than the Pill, perhaps due to a better compliance. Eight IUCD patients did not return for changing the device in due time after 36 months of use. Four out of 13 patients with cervical dysplasia did not return for prescribed controls of the cervical smear. The computerized medical record seems to be a powerful tool for the monitoring of high risk patients and clinical research in general practice.

Adolescent↗
PubMed1996

Colitis and lower abdominal mass by Actinomyces israelii in a patient with an IUD.

Abdominal actinomycosis is a rare disorder. The diagnosis is frequently missed preoperatively. We describe a patient who had had an intrauterine contraceptive device in situ for 5 years. She presented with a painful pelvicoabdominal mass, located between the uterus and rectum, and a colitis-like disease of the distal colon. Culture of the removed IUD demonstrated Actinomyces. She was intensively treated with intravenously penicillin for six weeks. Following this conservative treatment the abdominal tumor and the colitis-like symptoms totally disappeared. During two years follow-up she is free of symptoms and no signs of recurrence of the disease have been noticed. The case described here strongly underlines that Actinomyces infection should be born in mind in the differential diagnosis of a young female with an IUD, presenting with colitis, fever and an abdominal mass. Prolonged intravenously administered penicillin is warranted before surgery should be considered.

Actinomyces↗
PubMed1982

Placental candidiasis: report of three cases with a review of the literature.

Three new cases of placental candidiasis are reported. Two were associated with fetal cutaneous candidiasis and one with fetal systemic candidiasis. The systemic case was associated with an intrauterine contraceptive device. Infection of the placenta results in small 'granulomata' under the surface of the cord and a diffuse chorioamnionitis of the membranes and chorionic plate. In reviewing the 24 previously reported cases it can be seen that systemic. Candida infection of the fetus results in prematurity and death, infection can occur across intact membranes, and systemic candidiasis in the fetus is likely to be associated with an intrauterine device.

Adult↗
PubMed1973

Ceylon: continuing practice of contraception by acceptors of oral contraceptives and intrauterine devices in a field programme.

A follow-up study of oral-contraceptive and intrauterine-device acceptors in the early years of the Ceylon family planning programme was undertaken to determine the effect of a 1968 policy decision to cut the per cycle price of oral contraceptives by half and to allow nonclinical prescription and distribution of the pills by trained field midwives under medical supervision. While pill acceptance increased, study findings suggest that continuation did not. On balance, the intrauterine device proved much more effective than oral contraceptives in preventing unplanned pregnancies, reflecting the higher continuation rates of IUD acceptors. Although the availability of both methods clearly contributed to expansion of the programme, the demographic and administrative implications of initial choice of method, and the finding that pregnancy rates for pill users are not lower than for IUD wearers, suggest the need for more realistic counselling by clinic and field staff at the time of choice.

Adult↗
PubMed2000

[Etonorgestrel (Implanon) subcutaneous implant].

Etonorgestrel is provided in an subcutaneous implant to assure a contraception of long duration. This progestogen derived from desogestrel already used in several combined oral contraceptives acts by inhibiting ovulation and modifying the viscosity of the endocervical mucus. The contraceptive effect is rapidly obtained after insertion. After removal of the implant, the serum concentration of etonorgestrel rapidly drops down so that most patients ovulate after 3 weeks. The most important side effect of this contraceptive device is the bleeding irregularity encountered in a minority of patients (frequent or prolonged bleedings).

Contraceptive Agents, Female↗
PubMed2000

[Migration of an intrauterine device to the bladder].

The authors report the case of a patient presenting with recurrent urinary tract infection and deterioration of the general status. Ultrasonography, plain x-rays and especially cystoscopy demonstrated the presence in the bladder of an intrauterine contraceptive device inserted 4 years previously. Endoscopic removal combined with antibiotics ensured cure of this patient.

Adult↗
PubMed1981

Postpartum contraception.

Recently-delivered women who wish to avoid pregnancy should initiate contraception before ovulation. Since the return of ovulation is not predictable, regardless of the woman's lactation status and duration of postpartum amenorrhea, contraception should be initiated as soon as is reasonable after delivery. The choice of contraceptive method will depend on several factors, including: the woman's lactation status, the preference of the woman and her partner, and the health status of the newborns. For women who do not wish to have additional children, tubal sterilization through a minilaparotomy incision is the procedure of choice. For other women who are not lactating, all methods, with the exception of the use of cervical caps and diaphragms, may be initiated immediately after delivery. However, preference should be given to IUD use by lactating and non-lactating woman, especially for women who may not return for any additional postpartum care.

Contraception↗
PubMed1979

Laser light-scattering study of the effect of progesterone on sperm motility.

It is known that progestins can induce in the secretory cells of the cervix the excretion of a mucus that is highly viscuos, scanty, and impenetrable to spermatozoa. Mucus of this type is similar to that excreted during the luteal phase of the normal human menstrual cycle and the cow estrous cycle. It is a natural sequence to ask the question, do progestins also have a direct effect on sperm motility? With dynamic laser light-scattering we measured the motility of freshly washed human spermatozoa and of spermatozoa in the presence of a progesterone, both in terms of their swimming speed distribution as expressed in the spectrum of scattered light. The swimming speed was significantly reduced when the concentration of progesterone was three orders of magnitude greater than that of the physiologic level. This finding confirms the finding in earlier biochemical studies that progesterone has a distinct spermiostatic effect. We suggest this answer to the above question: progestin-releasing contraceptive devices may act on spermatozoa directly as well as in the secretory cells of the cervix.

Animals↗
PubMed1981

Contraception.

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Abortion, Induced↗