[The morphometric study of endometrium during long-term use of TCu220C IUD]

To observe the pathological changes of endometrium in women using TCu220C intrauterine devices (IUD) for 5-12 years, and to judge its long term safety.

A hundred women using TCu220C IUD for 5-12 years were randomly selected as IUD group. Samples of endometrium from the sites compressed by IUD and 1 cm apart were taken under hysteroscopy during proliferative phase. Another 100 women matched in age but not IUD users served as control group, and endometriums were taken by curettage. All the samples were studied for morphometry.

All pathological changes were localized in the areas of endometrium in direct contact with IUD but not the adjacent areas. Inflammatory reactions mainly lymphocytes infiltration were seen in all IUD samples with depth of 0.91-1.20 mm. Atrophy was seen in 25% of the cases using IUD for 5-10 years with an average area of 0.81 mm2, while in 71% of those using IUD for 10-12 years with an area of 1.50 mm2. Fibrosis was shown in 18% of the cases using IUD for 5-10 years with area of 1.87 mm2, and 100% in 10-12 years with area of 2.04 mm2. There was no hyper-proliferation and malignant changes in IUD group. Hemorrhage and necrosis existed in all cases using IUD for 10-12 years. In the IUD group all the cases showed asynchronization of endometrium.

It is safe for women using TCu220C IUD for 5-12 years. Since endometrial hemorrhage and necrosis were shown in women using IUD over 10 years, it is better to remove the IUD after 10 years if they have clinical symptoms.