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  • Title: Five years private practice experience of nulliparous women using copper IUD's.
    Author: Smith RP, Goresky DM, Etchell DM.
    Journal: Contraception; 1980 Apr; 21(4):335-42. PubMed ID: 7389354.
    Abstract:
    This is a study of 296 nulliparous women who used Copper IUD's as their method of contraception. At the time of first insertion the women had an average age of 21.6 years. The gross cumulative pregnancy rate rose to 11.8 over 5 years. The gross cumulative expulsion rate rose to 13.6 over 5 years and the removal rate for bleeding and pain to 20.4. The net rates were lower over 5 years (pregnancy 8.6, expulsion 11.2 and bleeding and pain 17.3). 29 women expelled their IUD's, of whom 20 underwent reinsertion. 43 women requested removal of their IUD's because of bleeding and pain, of whom 6 requested a reinsertion at a later date. Taking reinsertions into account, the continuation rate over 5 years was 55.2. Inability to insert the IUD was encountered in 28 women (8.6%). In 20 of the women cervical stenosis precluded the insertion of the IUD without local anesthetic, and in the other 8, the pain and/or syncope encountered during sounding the uterus precluded the continuation of the procedure. Insertion problems were encountered in 31 women (10.5%). Syncope occurred in 4 women and one of the women developed a 'grand mal' seizure. Clinically significant pelvic infection occurred within 30 days of insertion in 5 women (approximately 1% of insertions), and one woman developed pelvic infection from gonorrhoea. This is a study of 296 nulliparous women who used copper IUDs as their method of contraception. At the time of the 1st insertion, the women averaged an age of 21.6 years, and the gross cumulative pregnancy rate rose to 11.8 over 5 years. The gross cumulative expulsion rate rose to 13.6 over 5 years and the removal rate for bleeding and pain to 20.4. The net rates were lower over 5 years (pregnancy 8.6, expulsion 11.2, bleeding and pain 17.3). 29 women expelled their IUDs and 20 of them underwent reinsertion. 43 requested removal of their IUDs because of bleeding and pain and 6 of them requested reinsertion at a later date. Taking reinsertions into account, the continuation rate over the 5-year period was 55.2. Inability to insert the IUD was encountered in 28 of the women, or 8.6%. In 20 of the women, cervical stenosis precluded the insertions of the IUD without local anesthetic, and in the other 8 the pain during the sounding of the uterus precluded the continuation of the procedure. Insertion problems were encountered in 31 women (10.5%) and syncope occurred in 4 women, with 1 of them experiencing a grand mal seizure. Clinically significant pelvic infection occurred within 30 days of insertion in 5 women and 1 woman developed pelvic infection from gonorrhea. Over the 5-year study period, there was a good overall continuation rate. However, further study and long-term follow-up are necessary to investigate the fertility of nulliparous IUD users. While all the women in this study who had IUDs removed did conceive (N=10), this number is too small to generalize.
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