Intrauterine contraception of tubal pathology

The intrauterine device (IUD) is the second most common temporary physician-associated contraceptive method employed today. Because of the low motivation required for its use, it could be the ideal contraceptive method, were it not for certain associated complications, especially septic, that have led in some instances to sterility and even death. In order to investigate the relationship between tubal inflammatory changes and the use of IUDs, two hundred patients admitted to Mount Sinai Hospital Medical Center of Chicago for sterilization by the Pomeroy procedure were studied. The subjects were selected for study as follows: the first 50 patients using oral contraceptives, the first patients using IUDs, the first 50 patients using no contraceptives, and the first 50 women who were pregnant. All the subjects were young, sexually active, and similar in other parameters. To prevent any bias due to foreknowledge of IUD use, their tubal specimens were submitted to blind evaluation and then compared to clinical data. The highest incidence of inflammatory change was found among the IUD wearers, but oral contraceptives users and postpregnant women exhibited similar changes. The differences between the groups were not statistically significant. This does not confirm previous studies by other investigators, based on a different methodology, in which positive association is found between the use of IUDs and tubal sepsis. Thus, further blind studies may be required to clarify the relationship between the use of IUDs and tubal histological changes.