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Related Experiment Videos

Frameless versus classical intrauterine device for contraception.

P A O'Brien1, C Marfleet

  • 1Services for Women, Parkside Health, St Charles Hospital, Exmoor St, London, UK, W10 6DZ. PaulOBrien@care.prestel.co.uk

The Cochrane Database of Systematic Reviews
|November 1, 2001
PubMed
Summary

The frameless intrauterine device (IUD) shows similar performance to the TCu380A, with a potentially lower pregnancy rate in later years. Early expulsion issues with the frameless IUD require further investigation.

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Area of Science:

  • Reproductive Health
  • Contraception
  • Gynecology

Background:

  • The frameless intrauterine device (IUD) differs from classical IUDs by anchoring to the uterine fundus via a nylon thread, eliminating the need for a frame.
  • Modifications to the introducer for the frameless device were implemented following initial reports of early device expulsions.

Purpose of the Study:

  • To evaluate the hypothesis that the frameless IUD reduces the risk of expulsion and pregnancy compared to framed IUDs.
  • To assess the incidence of bleeding and pain necessitating early removal for both frameless and framed IUDs.

Main Methods:

  • A systematic review of randomized controlled trials comparing frameless IUDs with classical framed IUDs (TCu380A) for contraception.
  • Searches included the Cochrane Controlled Trial Register, MEDLINE, EMBASE, and Popline up to December 2000.

Related Experiment Videos

  • Data extraction was performed independently, and statistical analyses included rate ratios, rate differences, and heterogeneity testing.

    • Main Results:

    • Three trials involving over 5,800 women were included; earlier trials with a prototype introducer showed higher expulsion rates.
    • The World Health Organization (WHO) trial indicated a lower pregnancy risk with the frameless device between two and six years.
    • A recent trial using GyneFix with a new introducer showed no significant difference in early expulsions or pregnancies, but lower expulsion rates by year three.

    Conclusions:

    • Insufficient data exist to confirm that the new GyneFix introducer has resolved early expulsion issues.
    • The frameless device demonstrates comparable performance to the TCu380A, with a potential for a slightly lower pregnancy rate in later years.
    • Removal rates for bleeding or pain were similar between the frameless and framed IUDs.