Abstract

PIP: A review of 25 clinical trials conducted at the National University in Singapore included 10,055 insertions of 16 different IUDs between 1975 and 1988. The trials were conducted to assess the safety and complications of IUD use. The IUDs were inserted either immediately after abortion or at least 4 weeks after delivery or first trimester abortion. Overall, copper-releasing IUDs performed better than inert IUDs. Copper 7/Gravigard had the poorest pregnancy rate among the copper IUDs (6.3% at 48 months vs. 4.4%) as well as the highest use-related terminations (44.8% at 48 months vs. 33.4%). Use-related terminations included expulsion and terminations for other medical and other personal reasons and pregnancy. The Levonorgestrel Nova T IUD and the Copper T 380Ag IUD had the lowest pregnancy rates (no pregnancies over 5 years and 1 pregnancy in 5 years, respectively), but they were not significantly different than those for the Multiload Copper 250 IUD, the review's standard reference point (3.8% over 4 years). Among progestogen-releasing IUDs, levonorgestrel Nova T had the longest active life. The Copper 7/Gravigard, Lippes loop (size D), Dalkon Shield (standard), and OMGA T (size 1) IUDs had significantly higher pregnancy rates that the review's standard, MLCu250 (p .0001). The Latex leaf was significantly higher only after 12 months use (p .05). The Copper 7/Gravigard, Lippes loop (size D), Nova T, OMGA T (size 1), and Copper T 380Ag IUDs had significantly higher expulsion rates than did MLCu250. Women using the Copper 7/Gravigard, Lippes loop (size D), OMGA T (size 1), and Copper T 220/Proquinsert IUDs suffered significantly more pain/bleeding than those using MLCu250. Copper-releasing IUDs had significantly fewer use-related terminations than did the inert IUDs (p .001). The 2 Multiload IUDs (MLCu250 and MLCu375) had considerably fewer use-related terminations over the first 24 months of use.