Scanning and transmission electron microscopy of material adherent to intrauterine contraceptive devices

The material adherent to intrauterine contraceptive devices (IUCDs) has been studied by transmission and by scanning microscopy coupled with X-ray microprobe analysis. Inert (Lippes Loop D, Saf-T-Coil and Dalkon shield) and medicated (Copper 7 and Progestasert) IUCDs were removed for examination from uteri immediately after hysterectomy. The cellular material identified on the surface of all inert IUCDs consisted mainly of macrophages with some polymorphonuclear leucocytes, erythrocytes, a few platelets and fibrin fibres. Polymorphonuclear leucocytes were the principle cells on the copper devices. Larger numbers of cells were evident on the inert arms than on the active part of the Progestasert device. All the devices examined exhibited varying amounts of surface calcium deposition. The IUCDs which had been in utero for longer periods showed the greatest amount of calcium deposition. Although a less rapid calcium deposition appeared to occur on the Progestasert device, this deposition may influence the release of medications from IUCDs which are retained in utero for longer periods than one year.