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At least 19 recordsLinked to original sources
PubMed1978

The intra-uterine contraceptive device--contraceptive or abortifacient?

Further to the investigation of the possible mode of action of the intra-uterine contraceptive device (IUCD), an assay for the beta-specific subunit of human chorionic gonadotrophin (HCG) has detected endogenous chorionic activity 21 days after menstruation. In 22 proven ovulatory cycles, 7 patients wearing an IUCD had demonstrable serum HCG levels in 45% of these cycles. Abnormal menstruation was associated with the majority of cycles in which there was HCG in the serum. Subsequent luteolysis occurred in all cases. The results of this study may support the hypothesis that IUCD exerts its effect on the fertilized, implanted blastocyst, thus causing possible 'micro-abortion'. Caution should be exercised in the interpretation of HCG values in the follow-up of patients with hydatidiform mole or choriocarcinoma who are bearing IUCDs, since positive HCG levels may be due to an early, fertilized and implanted blastocyst and not to invasive tissue.

Adult↗
PubMed1992

Interactions between intrauterine contraceptive device use and breast-feeding status at time of intrauterine contraceptive device insertion: analysis of TCu-380A acceptors in developing countries.

OBJECTIVE: This paper is a reassessment of earlier findings from a preliminary analysis of data from a multicenter international trial regimen on breast-feeding and non-breast-feeding women in which events related to insertion, expulsion, and removal of the TCu-380A intrauterine contraceptive device (ParaGard 380) were investigated. STUDY DESIGN: Performance of the TCu-380A through 12 months after insertion was compared with life-table rate analysis, chi 2, Fisher exact test, or Student's t test. Variables were events reported during intrauterine contraceptive device insertion and events throughout the 12 months of study participation by breast-feeding status. RESULTS: Breast-feeding among intrauterine contraceptive device users was associated with fewer insertion-related complaints and lower removal rates for bleeding and pain. No uterine perforations were reported throughout the study. CONCLUSION: Differences in the performance of the TCu-380A intrauterine contraceptive device suggest physiologic effects associated with lactational amenorrhea. The TCu-380A intrauterine contraceptive device is a viable option for women breast-feeding at the time of intrauterine contraceptive device insertion.

Adult↗
PubMed1978

Production of fibrinolytic enzymes by macrophages on intrauterine contraceptive devices.

Intrauterine contraceptive devices (IUCDs) were removed from 44 patients with a variety of clinical conditions, and incubated in culture media. Following incubation for up to 96 hours the total numbers of macrophages on each device were counted. The Lippes loop and Saf-T- Coil had higher counts than the Copper 7. The counts on all devices were higher at mid-cycle and during menstruation and significantly higher in patients with menorrhagia and intermenstrual bleeding (P less than 0.0005). Samples of culture media were taken on a number of occasions for up to 96 hours for fibrinolytic studies, and fibrinolytic activity increased with time in 10 of 16 cases where fibrinolytic activity was detected. There was a weak positive correlation between the number of cells on each of the 10 devices which produced a rise in fibrinolytic activity and the highest level of activity produced by each of the devices (r = +0.59; P less than 0.05). Plasminogen activator activity was maximum early in the incubation period, while plasmin-like activity predominated in later samples. The possible role of macrophages in IUCDs in causing menorrhagia is discussed.

Cell Count↗
PubMed1975

Hormone-releasing silicone-rubber intrauterine contraceptive devices. Effect of incorporation of various compounds on intrauterine contraceptive devices in rats.

Intrauterine devices (IUD's) containing 0, 5, or 10 per cent by weight of progesterone, melengestrol acetate (MGA), norethindrone, norgestrel, medroxyprogesterone acetate, isoxsuprine, or R2323 or wound with fine copper wire were placed in one or both horns of cycling female rats. All the progestins improved retention of the silicone-rubber IUD's to some degree. The effects of these compounds on the estrous cycle, mating, ovulation, fertilization, tubal transport, and implantation varied among the compounds. Effects were local or systemic, depending upon the amount and the drug. Uterine motility studies showed clearly that 5 per cent MGA decreased uterine motility; however, no consistent results could be obtained using the other compounds in the same in vivo system.

Acetates↗
PubMed1979

Low-level, progestogen-releasing vaginal contraceptive devices.

Silicone rubber vaginal contraceptive devices of four different formulations, which release predetermined, controlled doses of three progestogens at four distinct levels, were designed and fabricated, and tested in 90-day clinical trials. Data obtained with 70 of the devices indicated that in vivo release rates (microgram/day +/- S.D.) for the formulations were: progesterone, 1400 +/- 30; norethindrone (two levels), 49.4 +/- 2.4, 196 +/- 21; d-norgestrel, 21.6 +/- 1.4. Clinical studies with these devices indicate that the women usually ovulate (with the exception of the high-dose norethindrone-releasing devices) while sperm penetration of the cervix was inhibited by all four fromulations, most consistently by the norgestrel-releasing devices.

Contraceptive Devices↗
PubMed1977

A controlled intrauterine contraceptive device trial.

Three intrauterine contraceptive devices (IUCD) the Lippes Loop, the Dalkon Shield and the Inhiband, were prospectively compared after their random allocation to patients. Over a 12-month period after insertion, the Dalkon Shield was shown to be significantly superior to the Inhiband. Significant differences were not demonstrated between Shield and Loop or Loop and Inhiband in the duuration of this trial. It is submitted that the methodology detailed could, and probably should be used for future IUCD assessments.

Australia↗
PubMed1977

Intrauterine deposition of calcium on copper-bearing intrauterine contraceptive devices.

Copper-bearing intrauterine contraceptive devices (IUDs) removed after various times in utero were examined by scanning electron microscopy and x-ray microanalysis of the elements present. As time in utero increased these devices became increasingly calcified. This calcification may limit the release of copper from the devices and decrease the specific contraceptive effectiveness of copper over an enert plastic device. Conversely, any teratogenic effects attributable to the copper may decrease with time in utero and depend on the extent of calcification. Even though the amount of copper in the device is not significantly diminished after two years, devices should not remain in situ for over two years because calcium accumulation probably prevents further diffusion of copper. Calcification can begin as early as six months after insertion. Consequently a careful review of the amount of time a copper-containing IUD should be left in situ should be undertaken.

Abnormalities, Drug-Induced↗
PubMed1992

Long term use of inert intrauterine contraceptive devices in 94 women in Israel.

A 22 year retrospective survey was undertaken in an Israeli family practice to determine how long inert (plastic only, unmedicated) intrauterine contraceptive devices could be safely left in place. Ninety four women were identified who had used 100 inert intrauterine contraceptive devices continuously for between five and 19 years. Fifty nine women complained of pain, increased uterine bleeding or increased vaginal discharge, but these were the reasons for removal of the device in only 32 women. There was only one case of pelvic inflammatory disease but this was treated without removal of the intrauterine contraceptive device. Of 14 women who requested to have their device removed after between five and nine years without having had any side effects, 11 women conceived within nine months. The results of the study indicate that inert intrauterine contraceptive devices can be safely left in place until the menopause. As it will take many years before the new type of copper devices can be shown to be as safe for long term use, it seems an appropriate time to reintroduce inert intrauterine contraceptive devices for women.

Adolescent↗
PubMed1975

Large bowel perforation by intrauterine contraceptive devices.

Two cases of large bowel perforation by intrauterine contraceptive devices are presented. Both the Lippes LoopTM and Dalkon ShieldTM have the potential of evoking omental adhesions and causing bowel perforation. These serious complications justify the immediate removal of a contraceptive device from the peritoneal cavity by either laparoscopy or laparatomy.

Adult↗
PubMed1975

Hysteroscopic removal of occult intrauterine contraceptive device.

Dilatation and curettage or hooking an occult intrauterine contraceptive device (IUD) may fail to recover the device on occasion. Theoretically, endoscopic observation should enable the controlled removal of this type of device. Of 200 patients who underwent hysteroscopic examination, 10 had an occult IUD. In 8 cases, the device was visible through the hysteroscope, and in 6 patients a successful removal was accomplished with this endoscopic technic. Failures and problems are discussed, and the importance of adequate preoperative study is stressed. Hysteroscopy is an effective procedure in the recovery of the occult intrauterine contraceptive device in selected nonpregnant patients.

Adult↗
PubMed1992

Rates and outcomes of planned pregnancy after use of Norplant capsules, Norplant II rods, or levonorgestrel-releasing or copper TCu 380Ag intrauterine contraceptive devices.

OBJECTIVES: The objectives were to measure rates of planned pregnancy and factors affecting these rates after use of very-long-acting contraceptive methods (Norplant or Norplant II implants, a levonorgestrel-releasing intrauterine contraceptive device, or the copper T (model TCu 380Ag) intrauterine contraceptive device. STUDY DESIGN: The design was a concurrent, multicenter prospective study of 372 women who stopped contraception for planned pregnancy. Analysis was by life-table, log-rank, and standard chi 2 methods. RESULTS: Pregnancy rates 12 and 24 months after cessation of contraceptive use were 82 and 89 per 100, respectively. Age at removal and family planning intentions at initiation of contraception were both significantly correlated with pregnancy rates (p less than 0.05), but former contraceptive regimen and duration of contraceptive use were not. Pregnancy outcomes did not deviate from normal limits and did not differ by contraceptive formerly used. CONCLUSION: Contraceptive implants releasing 30 micrograms/day of levonorgestrel or intrauterine contraceptive devices releasing 20 micrograms/day of levonorgestrel or having copper surface areas of 380 mm2 are associated with normal fertility after use for women seeking pregnancy at termination. Durations of use do not affect pregnancy rates.

Adult↗
PubMed1976

The Copper T 220C: a new long-acting copper intrauterine contraceptive device.

The Copper T(TCu) intrauterine contraceptive device (IUD) has been found to be an effective method of contraception but has the disadvantage of needing periodic replacement due to loss of copper through dissolution and fragmentation of the copper wire. Modification of the Copper T to overcome this disadvantage involved substitution of copper sleeves for wire on the vertical arm and the addition of copper sleeves to the horizonal arms to give an effective surface area of 220 sq. mm. of copper and an estimated life span of 20 years. A randomized comparative study was undertaken in 999 women to determine if the new model performed as well as the wire-wound Copper T 300. Net cumulative first-event rates at one year were as follows: TCu 220C-pregnancy 0.9, expulsion 3.7, removal for pain or bleeding 14.4; TCu 300-pregnancy 1.1, expulsion 3.1, removal for pain or bleeding 9.3. None of the differences in event rates were significant. If long-term follow-up confirms these findings, this new long-lasting copper intrauterine device could become the IUD of choice for all women.

Adolescent↗
PubMed1978

Copper intrauterine contraceptive devices in adolescent nulliparae.

Copper intrauterine contraceptive devices (IUCDs) were used in 243 young nulligravidae attending a gynaecological clinic for schoolgirls in Uppsala between March 1973 and June 1975; 226 of these girls (93%) were seen again during December 1975 making a total of 3138 months of observation. At the time of follow up, 126 patients (55.8%) still had the IUCD in situ; 20% had expelled the IUCD and in another 24.2% the IUCD had been removed because of bleeding and/or pain or because of suspected pelvic inflammatory disease (7 patients). Twelve of the girls conceived during the period of observation making the Pearl index 4.6; nine of the conceptions occurred within nine months of the insertion of the IUCD. Unlike others we do not advocate the use of the IUCD for young nulligravidae.

Adolescent↗
PubMed1978

Removal of intra-abdominal intrauterine contraceptive devices.

Thirteen cases of misplaced intrauterine contraceptive devices removed from the abdominal cavity over a two year period at the Chelsea Hospital for Women, are reviewed. Five of the six plastic devices were removable laparoscopically but all the copper containing devices required a laparotomy for removal because of an omental or peritoneal reaction.

Abdomen↗
PubMed1975

Clinical study of a progesterone-releasing intrauterine contraceptive device.

A double-blind clinical study was performed to determine whether the release of progesterone from an intrauterine contraceptive device (IUD) had any effect on IUD event rates. A total of 101 women received intrauterine contraceptive devices containing progesterone, resulting in the accumulation of 877 women-months experience; 100 women received IUD's without steroid, resulting in the accumulation of 780 women-months. The only significant difference was a higher incidence of pregnancy in those patients using devices which did not contain progesterone.

Adult↗
PubMed1978

[Ultra sonography for the localization of intra-uterine contraceptive devices (i.u.d.'s) (author's transl)].

The localization of uterine devices by ultra-sound techniques was investigated. Seven different types of intra-uterine contraceptive devices were checked under immersion in water and in the uterus of 585 wearers of I.U.D.'s. The quality of the ultra-sound pictures is mostly determined by the type of intra-uterine device. Under optimal conditions the investigated types of I.U.D.'s produced standard ultra-sound pictures which permitted their identification. The evaluation of the localization of the intra-uterine contraceptive devices in the uterus was reasonably accurate. At first the classification of normal localization, lower segment localization and cervical localization was used, and this was later enlarged by the measurement of the distance between the uterine fundus and the end of the device closest to the fundus. It was possible to estimate the contraceptive efficiency with these measurements. In 486 cases (83%) the intra-uterine device was found in normal position. In 24 (4.1%) of the cases removal and repeat insertion of the device was suggested. In 18 (3.1%) cases the device was not localized despite normal intra-uterine localization.

Anthropometry↗
PubMed1975

A Review of Commonly Used Intrauterine Contraceptive Devices.

The radiographic appearances of the most commonly used intrauterine contraceptives devices are reviewed, and methods are suggested to determine the extrauterine location of these devices. Complications resulting from the use of these devices are also discussed.

Foreign Bodies↗
PubMed1979

Pelvic actinomycosis in women using intrauterine contraceptive devices.

Several recent reports have indicated the possible association between pelvic infection caused by Actinomyces and the use of intrauterine contraceptive devices. Seven cases of infection or colonization of the female genital tract have been detected among women using intrauterine contraceptive devices (IUD's) at Grady Memorial Hospital, Atlanta, Georgia, from March, 1975, until May, 1977. No single IUD type has been incriminated. The shortest duration of consecutive IUD use before the diagnosis was two and a half years. Six of these cases were detected incidentally at the time of endometrial or endocervical biopsy. The diagnosis in each case was made histologically. One patient presented with severe pelvic inflammatory disease and had Actinomyces identified. This is the first reported death associated with pelvic actinomycosis in a woman using an IUD. This organism must be considered as a possible pathogen whenever a patient with an IUD develops pelvic inflammatory disease.

Actinomycosis↗