Abstract

PIP: IUD tolerability is related to the size and shape of the carrier frame of the copper-containing IUD. This study evaluates a critically selected group of 30 nulliparous women (those with uterine cavity length of 3.5 cm or less) who underwent insertion of the combined Multiload Copper 250-short (ML Cu 250-short) IUD. The women were aged 18 to 36 years. They were followed up between 6 months and 1 year. 1 patient with a very small infantile uterus (3.5 cm) had 2 IUD insertions and expulsions and was deemed not fit for intrauterine contraception. Another patient requested removal because of persistent bleeding, probably due to a fragile endometrium or a local bleeding disorder. 6 patients (20%) reported pre- and inter-menstrual pain, while 12 (40%) patients, including the patient who requested device removal, complained of prolonged bleeding following insertion of the ML Cu 250-short. Bleeding continued in majority of the cases for about 14 days following insertion. The bleeding pattern returned to normal after 2 months. No infections or pregnancies were reported. 4 of the patients who continued to use the device experienced some pain and/or discomfort. None of the patients who had experienced pain with previous devices experienced pain with the ML Cu 250-short. The length and width of the ML Cu 250-short appears optimal for the endometrial cavity of nulliparous women. The horizontal width of the ML Cu 250-short (18 mm) most closely approximates the 20 mm nulliparous uterine cavity width while the ML Cu 250-mini with a fundal horizontal length of 12 mm appears destined for use only by women with very narrow uterus. Hassons' wing sound 11 allows clinical graphical representation of the uterine cavity, enabling the inserter to select anatomically optimal device immediately in the clinic. The ML Copper 250-short appears highly suitable for use by nulliparous women.