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Clinical experience with intrauterine devices in a private practice
Advances in Contraception : the Official Journal of the Society for the Advancement of Contraception
|March 1, 1985
Summary
Intrauterine devices (IUDs) showed low rates of pelvic infection and did not compromise future fertility. Proper IUD sizing is crucial, as mismatched endometrial cavity and IUD lengths increase discontinuation event rates.
Area of Science:
- Reproductive Health
- Gynecology
- Contraception
Background:
- Intrauterine devices (IUDs) are widely used for long-term reversible contraception.
- Assessing the safety and efficacy of various IUD types is crucial for patient care.
- Previous studies have indicated potential risks and benefits associated with IUD use.
Purpose of the Study:
- To evaluate clinical experience with intrauterine devices over a 14-year period.
- To assess event rates leading to IUD discontinuation, including pelvic infections and fertility outcomes.
- To determine the relationship between IUD length, endometrial cavity length, and IUD-related events.
Main Methods:
- Retrospective analysis of 627 intrauterine device insertions in a private practice setting.
- Evaluation of event rates for discontinuation, pelvic infection, and future fertility.
- Correlation analysis between endometrial cavity length, IUD length, and adverse events.
Main Results:
- Low incidence of pelvic infections (0.7-2.2 per 100 woman-years) and comparable rates of pelvic inflammatory disease (PID) to the general population.
- No apparent compromise in future fertility following IUD removal.
- Significant increase in IUD event rates (pregnancy, expulsion, displacement, removal for bleeding/pain) when endometrial cavity length exceeded IUD length by ≥2.0 cm or was <0.5 cm.
Conclusions:
- Intrauterine devices are associated with infrequent pelvic infections and do not negatively impact future fertility.
- The difference between endometrial cavity length and IUD length is a significant factor influencing IUD event rates.
- Optimal IUD selection and insertion require careful consideration of uterine dimensions to minimize discontinuation events.