General assessment of the Multiload Cu250 intrauterine device. UK network of IUCD research clinics

A total of 803 fittings of the Multiload Cu250 were undertaken between May and December 1979 in the UK IUCD network co-ordinated by the Institute of Population Studies. University of Exeter. Each woman fitted with the device was followed in a prospective study until a pregnancy, expulsion or removal occurred or the woman was released from follow-up after 2 years of continuous use. Because of the large number of fittings undertaken it is possible to compare the experience of groups of women determined by a number of criteria. The most useful distinction was between those of differing parity. Comparisons have been made between nulliparous women, women of low parity (1 or 2) and those of high parity (greater than or equal to 3). By concentrating on the characteristics of the woman receiving the IUCD it is possible to provide those responsible for fitting IUCDs with information that will have predictive value in relation to specific categories of women. The results of the study show that, despite some variation between women of different parity, the Multiload Cu250 is comparable with other IUCDs currently available in the UK in terms of the relative risks of pregnancy and removal of the device after a complaint of bleeding or pain. The removal rate is biased towards complaints of pain among nulliparous women which is also reported to be present at the times of IUCD fitting and removal. As expected with a device of this configuration, the expulsion rate is low when compared with other devices. Once into the uterus this device appears to be an effective contraceptive but fittings in nulliparous women more frequently necessitate dilatation of the cervix and this is associated with more frequent reports of difficulty at fitting and complaints of pain.