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Factors associated with copper T IUD removal for bleeding/pain: a multivariate analysis
1Family Health International, Research Triangle Park, NC 27709.
Insights
Copper T IUD removal due to bleeding or pain is less likely with longer uterine length and skilled providers. Factors like amenorrhea and breastfeeding offer only short-term benefits against IUD removal.
Area of Science:
- Reproductive Health
- Contraception Research
- Clinical Trials
Background:
- Intrauterine devices (IUDs) are effective reversible contraceptives.
- Copper T IUD removal due to bleeding and pain can impact user satisfaction and continuation rates.
- Identifying factors influencing IUD removal is crucial for improving family planning services.
Purpose of the Study:
- To investigate factors associated with the removal of the Copper T IUD due to bleeding or pain.
- To analyze data from a large international multicenter randomized clinical trial.
Main Methods:
- Nested case-control analysis was employed.
- Included 143 cases of Copper T IUD removal for bleeding/pain within one year postinsertion.
- 2,023 controls had the IUD in place at their last follow-up visit.
Main Results:
- Longer uterine length (>70 mm) was associated with a decreased risk of IUD removal for bleeding/pain.
- Higher provider skill level was also linked to a reduced risk of IUD removal.
- Amenorrhea and breastfeeding at insertion provided short-term but not long-term protection against removal.
Conclusions:
- Uterine length and provider skill are significant factors in Copper T IUD retention.
- Family planning providers can use these findings to counsel patients and improve IUD insertion practices.
- Further research may explore long-term management strategies for IUD-related bleeding and pain.
Abstract:
To examine the factors associated with copper T IUD removal due to bleeding/pain, a nested case-control analysis using data from an international multicenter randomized clinical trial of the copper T-380A IUD was performed. One-hundred-forty-three cases with removal due to bleeding/pain within one year postinsertion and 2,023 controls with the IUD in place at last follow-up visit are included. Proportional hazards regression analysis indicated that uterine length greater than 70 mm and better IUD provider's skill were associated with a decreased risk of removal due to bleeding/pain. Amenorrhea and breastfeeding at insertion have short-term beneficial effects but less long-term effects. These findings may help family planning providers in counseling and practice.