The Copper T 220C: a new long-acting copper intrauterine contraceptive device

Abstract

The Copper T(TCu) intrauterine contraceptive device (IUD) has been found to be an effective method of contraception but has the disadvantage of needing periodic replacement due to loss of copper through dissolution and fragmentation of the copper wire. Modification of the Copper T to overcome this disadvantage involved substitution of copper sleeves for wire on the vertical arm and the addition of copper sleeves to the horizonal arms to give an effective surface area of 220 sq. mm. of copper and an estimated life span of 20 years. A randomized comparative study was undertaken in 999 women to determine if the new model performed as well as the wire-wound Copper T 300. Net cumulative first-event rates at one year were as follows: TCu 220C-pregnancy 0.9, expulsion 3.7, removal for pain or bleeding 14.4; TCu 300-pregnancy 1.1, expulsion 3.1, removal for pain or bleeding 9.3. None of the differences in event rates were significant. If long-term follow-up confirms these findings, this new long-lasting copper intrauterine device could become the IUD of choice for all women.

PIP: The copper T (TCu) 22OC, a new long-acting copper-bearing intrauterine device (IUD), was evaluated against the TCu 300 IUD in a randomized study of 979 women. 463 women received the TCu 22OC and 516 received the TCu 300 device. The TCu 22OC has 5 solid copper sleeves on the vertical arm of the T and 2 sleeves on the horizontal arm, thereby providing an effective surface area of 200 sq. mm. The estimated period of effectiveness of the device is 20 years, thus obviating the need for periodic replacement that is characteristic of devices bearing copper wire. At the end of 1 year, the net cumulative first-event rates were: TCu 22OC- pregnancy 0.9, expulsion 3.7, and removal for bleeding/pain 14.4; TCu 300 - pregnancy 1.1, expulsion 3.1, and removal for bleeding/pain, 9.3. The overall continuation rates were also similar. The TCu 22OC could become the IUD of choice if these preliminary findings are borne out by long-term studies.