Comparative Effectiveness and Safety of Intrauterine Contraception and Tubal Ligation
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February 23, 2022
Journal of General internal Medicine
Studies about
IUDs (Intra-Uterine Devices)
Copper intrauterine device use and HIV acquisition in women: A systematic review
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Read MoreThe collective evidence, including that from a large high-quality RCT, does not indicate an increased risk of HIV acquisition among users of Cu-IUDs. human immunodeficiency virus; intrauterine devices.
Levonorgestrel IUD: is there a long-lasting effect on return to fertility?
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Read MoreGiven the current gap in the literature and trends in LNG-IUD use in nulliparous young women, studies are needed that specifically look at the interaction of nulliparity, long-term use of LNG-IUD, and return to normal fertility. Herein, we review the available literature on the mechanism of action of IUDs with a specific focus on the effect on endometrial gene expression profile changes associated with IUDs.
Access to IUD removal: Data from a mystery-caller study
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Read MoreIn our current climate focused on improving access to IUDs, it is essential to address and reduce barriers to IUD removal when desired, in order to preserve reproductive autonomy.
Assessment of reasons of discontinuation of long acting reversible contraceptives (LARC) among married women visiting at Holy Family Hospital Rawalpindi. JSOGP 2016
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Read MoreReasons for discontinuation of IUD:
Bleeding Pattern (27.5%), Pain (25%), Weight Gain (5%); Other Reasons (42.5%)
Perinatal outcomes including long-term neuropsychiatric hospitalizations of offspring conceived during intrauterine contraceptive device use
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Read MorePregnancies in women who conceive with a removed or retained copper IUD are at an increased risk for short-term adverse perinatal outcomes, especially preterm delivery. For pregnancies that continued to at least 22 weeks, we found no benefit in IUD removal. However, the risk of long-term neuropsychiatric hospitalizations is not increased among offspring of these women.
One-year continuation of postpartum intrauterine contraceptive device: findings from a retrospective cohort study in India
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Read MoreAmong women who had their PPCuIUD removed, almost two thirds (64.9%) cited associated side effects like bleeding, pain in abdomen and discharge as the primary reason for removal.
Historical record-setting trends in IUD use in the United States
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“No other contraceptive method has undergone so rapid and thorough a change of medical reputation as that experienced by intrauterine devices over the past few years.” These words from United States-based contraceptive researcher Christopher Tietze in 1966 also characterize the last 10 years in the United States.”
Read MoreAdolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices
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Read MoreBecause adolescents are at higher risk of sexually transmitted infections (STIs), obstetrician–gynecologists should continue to follow standard guidelines for STI screening. They should advise adolescents who choose LARC methods to use male or female condoms consistently (dual method use) to decrease the risk of STIs, including human immunodeficiency virus (HIV). Obstetrician–gynecologists should counsel all sexually active adolescents who do not seek pregnancy on the range of reversible contraceptive methods, including LARC, and should help make these contraceptives readily accessible to them.
Recent intrauterine device use and the risk of precancerous cervical lesions and cervical cancer
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Read MoreRecent levonorgestrel-IUD use may be associated with CIN2, a lesion with a high rate of regression, but not CIN3, which is considered a true pre-cancerous lesion. The observed association between levonorgestrel-IUDs and CIN2+ was modest but warrants further investigation. It may have clinical importance for contraceptive counseling if this finding is shown to be consistent across other studies and other populations.
Perforation risk and intra-uterine devices: results of the EURAS-IUD 5-year extension study
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Read MoreThe overall perforation rate was 2.1 per 1000 insertions for LNG-IUS users 1.6 per 1000 insertions for copper-IUD users……. LNG-IUS users had a borderline higher risk of perforation compared with copper-IUD users.
Forty-five (58%) of the 77 perforations were associated with suspected risk factors……
Breastfeeding…… and time since delivery remained significant risk factors in perforations detected after 12 months.
No perforations resulted in serious injury to intra-abdominal or pelvic structures.
Chronic Systemic Toxicity Study of Copper Intrauterine Devices in Female Wistar Rats
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The aim of this study was to evaluate the chronic systemic and local toxicity of a copper intrauterine device in a rat model. These results obtained at different dosages and long-term implantation provide solid data confirming the safety of long-term use of Cu-IUDs. However, the elevated leucocyte levels found in this study warrant further investigation.
Includes lots of references to other studies.
Read MoreProvider Bias in Long-Acting Reversible Contraception (LARC) Promotion and Removal: Perceptions of Young Adults
/Read MoreWe encourage contraceptive counseling and removal protocols that directly address historical reproductive injustices and that honor patients' wishes.
Some adverse effects of copper-IUD
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Read More“Retracted and detached strings were observed somewhat more often in women wearing Cu-7-IUD's. The number of such cases was, however, not large enough to warrant a statistical comparison.”
Clinical Experience with the Copper 7 Intrauterine Device
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Read More“There was a decrease in contraceptive effectiveness after 12 more months' use.”
Copper-7 intrauterine device (Gravigard). Report of experience.
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Read More“Compared with oral contraceptives copper IUDs have 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.”