[Copper-7 intrauterine device (Gravigard). Report of experience]

Within 2 years 258 women aged 16 to 42 years were fitted with a copper-7-IUD (Gravigard, Searle). 45% of these patients were nulliparous women. Follow-up studies were provided in 236 cases in a total of 2717 women-months according to an average time of observation of 11.5 women-months per patient. Altogether there occurred 5 unwanted pregnancies with a Pearl-Index of 2.3. Partial or total expulsion occurred in 27 cases (11%). Fourteen out of 27 expulsions were noticed within the first 2 months after insertion. Removals for medical reasons were requested in 36 cases-in the majority (26 cases) because of bleeding and pain. Thirteen women desired removal of the IUD in order to get either pregnant or sterilized. The continuation rate after 2 years was 73%. The highest number of drop-outs occurred within the first year after insertion (60 cases = 23%) whereas only 4% drop-outs occurred in the 2nd year. It was suggested that the low continuation rate might be partially due to the high number of physicians (19) participating in this study. The most important side effects of the copper-7-IUD in situ were irregular bleeding, intermenstrual pain and discharge. Irregular bleeding and pain decreased markedly after the first year, while slightly prolonged periods persisted in 30 to 50% of all patients. Compared with oral contraceptives copper IUDs hav less severe side effects but less safety at the same time-especially for the younger fertile age group. Therefore they should be offered to young nulliparous women only for a limited period of time.