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  • Title: Surface changes in intrauterine contraceptive devices after variable use.
    Author: Keith L, Bailey R, Berger GS, Method M.
    Journal: Am J Obstet Gynecol; 1985 May 01; 152(1):69-78. PubMed ID: 3993713.
    Abstract:
    Four used intrauterine contraceptive devices and two new control devices were studied by scanning electron microscopy. All intrauterine contraceptive devices were found to have surface deposits that differed not only from site to site on a given device but between devices. A finding of this study not previously described in the literature was the observation of a euhedral crystal rosette of an apatite mineral group [Ca5(PO4)3(F,Cl,OH)] on the Lippes Loop that had been in situ for 15 years. Scanning electron microscopy was used to study 4 used contraceptive devices and 2 new control devices. A Lippes Loop No. 1 (in situ 15 years), a Saf-T-Coil No. 1 (in situ 8 years), a Cu-7 No. 2 (in situ 4 years), and a Cu-T No. 1 (in situ 6-1/2 years) were placed in 2.5% glutaraldehyde in Millonig's buffer immediately after their removal. Unused IUDs -- the Cu-7 No. 1 and the Lippes Loop No. 2 -- also were placed in glutaraldehyde immediately after removal from their sterile envelopes. After suitable fixation, all specimens were prepared for scanning electron microscopy according to standard techniques. Samples were mounted on aluminum studs and vacuum evaporated with gold-palladium in a ratio of 60:40. A MEOL JSM 50A scanning electron microscope was used. Photographs were taken with Polaroid P/N 55 film. The intrauterine portion of 1 of the 2 strings of the Lippes Loop No. 1 demonstrated an irregular distribution of plaquelike encrustation with a smooth string surface visible underneath the plaque. In contrast, part of the intravaginal portion of the 2nd string was so heavily encrusted that the underlying surface was not visiable at any point. The body of the Lippes Loop showed 2 different encrustation morphologic characteristicss. These were seen on both sides of the clearly visible molding mark that bisects the IUD. 1 pattern had the appearance of a continuous mud-cracked encrustation. On a more superior portion of the IUD body several rounded masses appeared to project from the surface. The dissimilarity of the Saf-T-Coil to the Lippes Loop No. 1 centered around the absence of euhedral crystalline forms and the presence of "bulbous nodules" surrounded by plaquelike encrustation that appeared fibrous at times and granular at others. In some areas a netlike matrix was visible, suggesting that the nodules represented filled-in areas of a fibrous network. On other areas of the IUD the superficial encrustations had broken off revealing an underlying and more regular granular base of plaque on the IUD surface. An observation not seen on any other device examined was the presence of spaghetti-like structures projecting from a coherent base of the plaquelike encrustation on the intrauterine portion of string of this device. The observations of the Cu-7 No. 1 were characterized by thick and dense encrustation; "bulbous nodules" were absent. The surface of the IUD body and its string had plaque-like encrustations with a more textured appearance. There were 2 notable features to the encrustation of the Cu-T, No. 1: the thick and contiguous nature of the encrustation; and a series of symmetrical cracks in an underlying base coating seen at a higher magnification.
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