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At least 19 recordsLinked to original sources
PubMed1993

The TCu-380A (AG), MLCu375, and Nova-T IUDs and the IUD daily releasing 20 micrograms levonorgestrel--four pillars of IUD contraception for the nineties and beyond?

With recent studies repeatedly showing results clearing the IUDs from their formerly suspected role in causing pelvic inflammatory disease (PID), very likely IUD use will further increase worldwide. While most previous IUDs have been withdrawn from the US market during the 1980s, newer and more effective IUDs have subsequently been developed; and some, marketed. Four of these devices will probably become the pillars for future IUD contraception worldwide. This review evaluates the relative performance and safety of these four devices. Consistent findings have proven the Copper-T 380A (Ag) and the Multiload-375 (MLCu375) IUDs to be safe with high and long-lasting efficacy. The Nova-T IUD showed favorable results in some studies, but showed deteriorated efficacy after three years of use in others; more studies are needed. Studies show that the IUD that daily releases 20 micrograms levonorgestrel (LNG-20) is associated with the highest efficacy in preventing accidental pregnancy among the four devices, but it has a uniquely high medical removal rate because of amenorrhea. This steroid-releasing device could be a high-performance IUD if this type of medical removal can be reduced through patient counseling devised according to local cultural background.

Evaluation Studies as Topic↗
PubMed1987

Early chorionic activity in women bearing inert IUD, copper IUD and levonorgestrel-releasing IUD.

Early chorionic activity was assessed in the premenstrual days by means of serum HCG beta-fraction. As control, a group of women with no contraceptive use was studied; early chorionic activity was detected in 31.8% of the cycles. In the group bearing an inert IUD the incidence was 20%, which did not differ from the control; while in the medicated IUD groups (Cu-IUD and LNG-IUD) the incidences were 4.8% and nil, respectively. Both medicated IUD groups showed a significant difference when compared with the control, as well as the inert IUD groups. The meaning of these findings, pointing out differences in the main mechanism of action between inert and medicated IUDs, is discussed.

Adult↗
PubMed1995

The TCu 380A IUD and the frameless IUD "the FlexiGard": interim three-year data from an international multicenter trial. UNDP, UNFPA, and WHO Special Programme of Research, Development and Research Training in Human Reproduction, World Bank: IUD Research Group.

The TCu 380A and FlexiGard IUDs were compared in a randomized multicenter trial including 28 institutes in 13 countries. There were 53 insertion failures with the FlexiGard and one with the TCu 380A. There were 2184 successful insertions of the TCu380A and 2102 of the FlexiGard device. The three-year pregnancy rates for the TCu 380A and FlexiGard were similar (1.6 and 1.9 per 100 women, respectively) but the FlexiGard three-year expulsion rate (7.4 per 100 women) was significantly higher than that of the TCu 380A (4.4 per 100 women). The insertion technique for the FlexiGard needs to be improved in order to lower the expulsion rate.

Adult↗
PubMed1996

Effective, despite misconceptions. The IUD with progesterone must be replaced once a year, while the IUD with copper may be left in for up to 10 years.

Many women have misconceptions about the intrauterine device, or IUD. The IUD is a safe and effective contraceptive method for many women. It is more effective than the condom, diaphragm, or spermicides, and also is more convenient than these methods, since it doesn't interfere with different sexual activities. The IUD is a small, T-shaped plastic device containing either copper or progesterone, and is inserted by a doctor into a woman's uterus. A thin plastic thread (1-2 inches long) protrudes through the cervix so that the user can cross-check to make sure the device is in place. Depending on the IUD type, small amounts of copper or progesterone are slowly released to prevent fertilization of the egg, or to prevent a fertilized egg from attaching to the uterine wall. The IUD with progesterone must be replaced once a year, while the IUD with copper may be left in for up to 10 years. The IUD is a good choice for women who can't take oral contraceptives and for women who have completed their families but want surgical sterilization. Because the IUD carries a slightly higher risk of ectopic pregnancy (a fertilized egg that implants outside the uterus), it is not usually recommended for women who already are at increased risk of the condition, such as those who have had a pelvic infection, a previous ectopic pregnancy or multiple sex partners. Common side effects of the IUD include some discomfort while the IUD is being inserted and some cramping and spotting during the first few weeks after insertion. Menstrual periods usually become slightly longer and heavier in women using the copper IUD, but become lighter in women using the progesterone IUD. Occasionally, the IUD will slip partially out of the uterus or be expelled entirely in the first few months.

Contraception↗
PubMed2002

Study on the effects of FCu-IUD and FICu-IUD on matrix metalloproteinases in human uterine flushing and endometrium.

The activity of matrix metalloproteinases (MMPs) in the uterine flushing and endometrial tissue of normal adult women wearing FCu-IUD (fixed Cu-IUD) or FICu-IUD (indomethacin-releasing FCu-IUD) was observed by using zymography on SDS-PAGE containing gelatin. The results showed that the activity and kinds of MMPs in FCu-IUD group were increased significantly as compared with themselves before being inserted FCu-IUD. However, compared with the FCu-IUD group, the activity of some kinds of MMPs in the FICu-IUD group was decreased significantly. These data suggest that IUD can enhance the activity of MMPs in human endometrium, intermediated by prostaglandins, and MMPs may have relation to IUD-induced menorrhagia and indomethacin reduces IUD-induced menorrhagia by partly inhibiting MMPs synthesis.

Adult↗
PubMed1991

An evaluation of the levonorgestrel-releasing IUD: its advantages and disadvantages when compared to the copper-releasing IUDs.

The levonorgestrel-releasing IUD (LNG-IUD-20), providing a daily dose of 20 ug, has recently been approved for marketing in Finland. The IUD's high efficacy in preventing accidental pregnancy and other numerous positive features make it a promising contraceptive device for worldwide use, just like the currently available T-shaped copper-releasing (TCu) IUDs. This paper reviews published reports comparing the LNG-IUD-20 and the currently used TCu IUDs. The merits and disadvantages of the steroid-releasing IUD are evaluated in terms of its performance and other special features relative to the TCu IUDs. Also, a number of future studies with medical and programmatic importance are proposed. A broader understanding about these two IUD families will facilitate their use in a complementary way for family planning programs.

Drug Evaluation↗
PubMed1986

Time to conception after IUD removal: importance of duration of use, IUD type, pelvic inflammatory disease and age.

Some investigations of IUD use have demonstrated impaired ability to become pregnant after removal, while others have not. None of these studies, however, have adequately considered such potentially influencing variables as age and a history of pelvic inflammatory disease (PID). To study the effect of length of IUD use, IUD type and the modifying influences of age and PID history on time required to conceive, we followed women trying to become pregnant after removal of their IUD. Five hundred forty women in Ljubljana, Yugoslavia who were first fitted with an IUD between 1964 and 1972 and had their IUD removed in order to become pregnant were followed through 1980. We found no relationship between the duration of IUD use or type of IUD used, but increasing age and a history of PID each decreased the monthly probability of conception. These findings, along with other recent work, indicate that IUDs are a safe and efficacious contraceptive for women at low risk for sexually transmitted diseases.

Adult↗
PubMed1986

Epidemiological data, cytology and colposcopy in IUD (intrauterine device), E-P (estro-progestogens) and diaphragm users. Study of cytological changes of endometrium IUD related.

The author compares the epidemiological, cytological and colposcopical data found in IUD users, with a control population of estro-progestogens and condom users. The age, parity and clinical symptomatology, mainly leukorrhea, was higher in IUD users. At the colposcopic examination a normal pattern was found in condom users more frequently, but the suspect colposcopic signs were frequently associated with the use of the IUD. The oncologic evaluation of smears showed a slight dysplasia in 17.65% and 10.53% in IUD users and estro-progestogen users respectively. The only case of carcinoma in situ was found in the IUD users group. The bacteriological diagnosis on the smears did not reveal a quantitative difference in the three groups, while a qualitative difference was found, particularly with a high frequency of Trichomonas vaginalis and Corynebacterium vaginalis, and one case of Actinomyces in IUD users. The cytological study of the endometrium obtained by mono-use devices, revealed an aspect of aspecific non plasmacellular endometritis in 75% of the cases; a dysfunctional hormonal cytological aspect in 32.50%, and the oncological evaluation in 60% of the cases revealed atypical endometrial cells IUD related. No neoplastic lesion was found. The author concludes that the use of IUD must be prudent and accurate follow up must be carried out.

Abortion, Spontaneous↗
PubMed1975

The effect of a copper iud and "inert" iuds on the incorporation of 3-h-thymidine and 5-3-h-uridine into the endometrium of the rabbit after stimulation with human chorionic gonadotropin.

The present investigation studied the influence of different types of intra-uterine devices (IUDs) especially that of a copper IUD, on the incorporation of 3-H-thymidine and 5-3-H-uridine into the endometrium of the rabbit. "Inert" IUD. In non-stimulated rabbits, the incorporation of 3-H-thymidine was increased in the copper influenced horn. The incorporation of 3H-thymidine in control and Cu-IUD-containing horns reached a maximum at 48 hours after HCG stimulation, but was significantly lower in the copper-containing horn than in the control horn. On the fifth day of pseudopregnancy, the incorporation of 3-H-thymidine was significantly higher in the copper IUD-containing horn. The total amount of DNA in the endometrium increased during early pseudopregnancy, but this increase was markedly reduced in the presence of copper. The copper IUD had no influence on the rate of incorporation of 5-3-H-uridine in non-stimulated rabbits, whereas it caused a higher incorporation on the fifth day of pseudopregnancy.

Animals↗
PubMed1991

Prevention of IUD-related pelvic infection: the efficacy of prophylactic doxycycline at IUD insertion.

It is believed that much of the small increased risk for developing pelvic inflammatory disease (PID) associated with the use of an intrauterine device (IUD) appears to be caused by bacterial contamination of the endometrial cavity at the time of insertion. Previous research suggests that use of prophylactic antibiotics immediately prior to IUD insertion may reduce the risk of developing PID. This paper presents results from a randomized clinical trial of 1485 women in Ibadan, Nigeria evaluating the effectiveness of 200 mg of doxycycline (versus placebo) given orally at the time of IUD insertion in reducing the incidence of PID during the first three months of IUD use. Rate of PID infection in the doxycycline-treated group was not significantly lower than that in the placebo-treated group. The rate of unscheduled IUD-related visits to the clinic also was not significantly lower among the doxycycline-treated group. However, the incidence of PID was low (21 cases) for both study groups. Aseptic conditions during IUD insertion, follow-up visits with short intervals to monitor health, and treatment of opportunistic infections may have reduced the potential of PID within this population.

Administration, Oral↗
PubMed1976

The effect of a copper IUD and various "inert" Iuds on the histological picture of the rabbit endometrium during early pseudopregnancy and pregnancy.

The influence of a copper IUD and two "inert" IUDs on the histological picture of the rabbit endometrium during early pseudopregnancy and early pregnancy was studied. The copper IUD markedly inhibited the endometrial maturation during the first five days of both pseudopregnancy and pregnancy. The "inert" IUDs had no such effect. The copper IUD prevented the normal response of the rabbit uterus to 17-beta-estradiol in castrated animals. The observed effects of the copper IUD might seriously interfere with the normal process of implantation.

Animals↗
PubMed1994

Improved utilization of spacing methods--intrauterine devices (IUDs) and low-dose combined oral contraceptives (OCs)--through re-orientation training for improving quality of services. Indian Council of Medical Research Task Force on IUD and Hormonal Contraceptives.

A multicentre study was conducted by the Indian Council of Medical Research (ICMR) for improving the utilization of intrauterine devices (IUDs) and oral contraceptives (OCs) at the Post Partum Centres (PPCs) run by District/State Health Authorities. The ICMR's network of Human Reproduction Research Centres (HRRCs) had the technical responsibility for providing re-orientation training to health functionaries (medical and paramedical) of the PPCs for better quality of services and follow-up care for IUD and OC users. The uniform training module was utilized by all HRRCs which specifically assured for improving the counselling/motivational skills as well as screening procedures and management of side-effects and follow-up care by the health functionaries. A total of 4,808 IUD acceptors (2,446 of CuT 200 and 2,362 of CuT 380A) were observed for 84,070 women-months of use (42,433 and 41,637 months for CuT 200 and CuT 380A, respectively). The cumulative method failure rate at the end of two years was 0.7 per 100 users with CuT 200 and 0.3 per 100 users with CuT 380A. No perforations were reported with either types of the CuT devices. The reasons for discontinuations, like pain/bleeding and pelvic infections, were similar with both types of devices. The continuation rates with either CuT 200 or CuT 380A were around 89 and 76 per 100 users at the end of first year and second year of use, respectively, and were comparable. These observations at the post partum centres were similar to those observed earlier by the ICMR in phase III controlled clinical study. A total of 1,961 women were enrolled in the low-dose combined oral contraceptive (OC) group and were followed for 26,462 women-months of use. Two subjects reported pregnancy during regular use of pill, giving the method failure rate of 0.2 per 100 users at 2 years. The continuation rates of OC users were 58 and 37 per 100 users at the end of first year and second year, respectively. The major reasons for discontinuations were lost to follow-up, desire for pregnancy and other personal reasons. In spite of all efforts made by PPC staff as well as HRRCs to do follow-up, the lost to follow-up at two years was around 20 percent for IUD and 31 percent for oral pill users. These data suggest that while the re-orientation training package improved the quality of care resulting in higher continuation rates of IUDs and OCs at PPCs, the issue of follow-up care still requires further improvement in the National Programme.

Adult↗
PubMed1982

IUD and salpingitis: a prospective study of pathomorphological changes in the oviducts in IUD-users.

A prospective study on pathomorphological changes in the oviducts in 253 women who underwent voluntary sterilization via posterior colpotomy performed at the Catharina Ziekenhuis, Eindhoven, was performed in order to investigate the effect of the intrauterine device (IUD). Some form of salpingitis was found in 54% of the IUD-group and in only 6% of the control group (P less than 10(-6), four-fold table, chi-squared test.) Microbiological study in 51 patients did not explain the pathoanatomical changes. As the IUD-and control-groups were comparable in all investigated parameters, the inflammatory reaction must be caused by the method of contraception.

Adult↗
PubMed1994

Effect of prophylactic antibiotics on morbidity associated with IUD insertion: results of a pilot randomized controlled trial. IUD Study Group.

The efficacy of administering an antibiotic prior to IUD insertion to reduce the risk of introducing an upper genital tract infection during the procedure has not yet been established. Two double-blind randomized studies conducted in Africa comparing a 200 mg prophylactic dose of doxycycline with a placebo did not conclusively identify a reduced risk of post-insertion pelvic inflammatory disease (PID). A clinical trial of comparable design is currently under way in the US. This multi-site trial will evaluate whether use of an antibiotic prior to insertion reduces the risk of IUD removal for all medical reasons, including upper genital tract infection, within the first three months after insertion. This paper reports on the pilot phase of this study, which was designed to test the protocols and data collection instruments in advance of the full-scale clinical trial. A total of 447 prospective IUD (TCu-380A) users were randomly assigned to receive either a 200 mg dose of doxycycline or a placebo one hour before IUD insertion. 3.6% (8/219) of participants who received the antibiotic had the device removed for medical reasons (infection, bleeding, cramping, etc.) within three months post-insertion compared to 4.5% (10/223) of participants who received the placebo. This reduction in the removal rate was not statistically significant given the limited size of the pilot study (RR = 0.81; 95% CI 0.28-2.29). Only two subjects, one from each treatment group, met the diagnostic criteria for acute PID. The overall three-month retention rate was 91.8% for the antibiotic group and 89.7% for the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2003

Follow-up visits after IUD-insertion: sense or nonsense? A technology assessment study to analyze the effectiveness of follow-up visits after IUD insertion.

The objective of this study is to evaluate whether regular follow-up after insertion of an IUD protects against the risk and side effects of this contraceptive device. To study the effectiveness of the follow-up visits done after IUD insertion, we compared a group of women with regular follow-up visits (group A: after 6 weeks, 3, 6 and 12 months) with women who had non-regular follow-up visits (group B: after 6 weeks and annually) for pregnancy, expulsion rates and discontinuation. A total of 280 women were included (group A: 199, group B: 81). Three pregnancies and 2 unnoticed expulsions were observed. The detection rate of an unnoticed expulsion is 0.35 and 0.11 per 100 visits for, respectively, the visit 6 weeks after insertion and all successive visits. Women in group A came significantly more frequently for unscheduled visits [relative risk (RR): 1.6; 95% confidence interval (CI): 1.03-2.4]. The number of discontinuations, pregnancies and expulsions did not differ between groups, but women in group B had their IUD removed earlier (p < 0.01). We conclude that regular follow-up after the insertion of an IUD is not effective.

Adult↗
PubMed1982

Comparative prolactin profiles in IUD users and non-IUD users.

Starting from the 10th day of the menstrual cycle through onset of the subsequent menstrual bleeding, daily blood samples were collected from 14 women using Copper T IUDs and 10 normal control women. The serum samples were analysed by radioimmunoassay (RIA) for human prolactin (hPRL) and human luteinizing hormone (hLH). hPRL values were subjected to statistics. Episodic patterns of hPRL were observed for all subjects. IUD users show generally lower daily levels of hPRL than non-IUD users, but the apparent differences were statistically insignificant.

Female↗