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  • Title: Clinical experience with today's IUDs.
    Author: Pasquale S.
    Journal: Obstet Gynecol Surv; 1996 Dec; 51(12 Suppl):S25-9. PubMed ID: 8972499.
    Abstract:
    Today's IUDs are an extremely safe and effective method of contraception. The progesterone-containing system is associated with diminished menstrual blood loss; however, it must be removed and reinserted annually. The copper-containing IUD is effective for up to 10 years, and is protective against ectopic pregnancy. When used for at least 18 months, the copper IUD is the most cost-effective of all contraceptive methods available in the U.S. (37). There are low rates of adverse events associated with IUD use, with no systemic metabolic effects. There is a rapid return to previous fertility, comparable to other contraceptive methods, including oral contraceptives. In addition, in the event that a woman does become pregnant when using an IUD, the IUD does not increase the risk of congenital abnormalities. Finally, when inserted into appropriate candidates, there is a low risk of pelvic inflammatory disease. The two IUDs currently available in the US--the progesterone-containing device and the copper T380A--are among the most effective contraceptive methods. The progesterone-containing IUD has an efficacy rate of 2.9 pregnancies per 100 women-years and a continuation rate of 80% after one year. The copper T380A has an annual pregnancy rate of less than 1 per 100 users constant over its 10-year life span and first-year continuation rates in the range of 77-86%. The copper device has a significant deleterious effect on sperm and their motility and confers protection against ectopic pregnancy. When used for at least 18 months, the copper IUD is the most cost-effective contraceptive method available in the US. The risk of pelvic inflammatory disease (PID) is related specifically to the IUD insertion process and the woman's risk of acquiring a sexually transmitted disease. The relative risk of PID among IUD users who have 1 sexual partner is approximately 1.1% and decreases with increasing duration of use. Finally, in the event a woman does become pregnant when using an IUD, the device does not increase the risk of congenital abnormalities.
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