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  • Title: A longitudinal study of serum iron indices and haemoglobin concentration following copper-IUD insertion.
    Author: Goh TH, Hariharan M, Tan CH.
    Journal: Contraception; 1980 Oct; 22(4):389-95. PubMed ID: 7449387.
    Abstract:
    The increase in menstrual blood loss associated with copper-bearing IUDs may cause or aggravate pre-existing anaemia. In order to evaluate this risk, 84 Malaysian women wearing copper-IUDs were studied longitudinally by means of serial measurements of blood haemoglobin concentration (Hb), serum iron (S/Fe) and transferrin saturation (T/S). The initial Hb was under 12 gm% in 33.7% of patients. The mean Hb showed no significant change up to 12 months while S/Fe fell significantly at the end of this time; the T/S was significantly reduced as early as 6 months post-insertion. There is a significant risk of anaemia following copper-IUD insertion, particularly with long-term usage. Progestogen-releasing IUDs may offer the most feasible solution to this problem in our local context since oral medication with iron or drugs to reduce menstrual blood loss is not practicable. Insertion of copper-bearing IUDs has been associated with a 50% increase in menstrual blood loss (MBL), which is a potential cause of anemia in women, particularly those from developing countries. This study is an attempt to evaluate this risk. 3 copper IUDs (Copper-7, T-220C and Multiload 250) were randomly assigned to 84 healthy Malaysian women (mean age, 27.9; average parity, 2.4). 28 patients had Cu-7, 32 Multiload 250 and 24, T-220C. Blood samples were collected for measurement of hemoglobin (Hb), serum iron (S/Fe), unbound iron-binding capacity (UIBC), and transferrin saturation (T/S). There was no significant drop in mean Hb up to the 12-month visit (p 0.3). The S/Fe progressively declined, with significant levels being reached at 12 months (p 0.01). The T/S exhibited a significant drop as early as 6 months following insertion (p 0.05). There were no signficant differences in mean Hb, S/Fe, and T/S levels between the 6th- and 12th-month visits (p 0.5). A significant risk of anemia following copper IUD insertion is noted, particularly with long-term usage. Though further trials are necessary, the progestogen-releasing IUDs may provide the most feasible solution to the risk of anemia in the Malaysian context.
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