Intra-uterine contraceptive devices (IUDs) in relation to uterine histology and microbiology

Histological and microbiological examinations were made of 90 uteri taken in association with abdominal hysterectomy. Thirty-one women had an intra-uterine contraceptive device (IUD) in utero at the time of operation, 16 women had previously used an IUD, while 43 had never used one. A chronic inflammatory reaction was seen significantly more often in the fallopian tubes of women with an IUD in situ (21/31, 68%) than in those who had never used an IUD (7/43, 16%). In contrast, non-active post-inflammatory tubal changes were found less frequently in women with an IUD in situ (6%) than in women who had never used an IUD (16%). All tubes were sterile, expect for two with apathogenic microbes. An endometrial inflammatory reaction was found in 4 women with an IUD in situ and in one woman who had never used an IUD. The possibility of tubal infertility must be borne in mind when planning IUD contraception.