The effect of the intrauterine contraceptive device on endometrial secretory function: a possible mode of action

Abstract

The effect of the intrauterine contraceptive device (IUD) on the composition of endometrial secretion has been studied using the monoclonal antibody D9B1. The antibody binds to a polypeptide-associated oligosaccharide epitope that is secreted by endometrial epithelium in the secretory phase with a maximum around the time of implantation. In endometria affected by the IUD in situ, a significant reduction in epitope expression has been observed using immunohistochemistry. This defect can occur against a background of normal secretory differentiation and in the expectation of normal ovarian stimulus. The data provide new insight into the contraceptive mechanisms of action of the IUD.

PIP: The effect of the presence of a copper-containing IUD in situ on endometrial tissue was studied in 38 women, only 2 of which were nulliparous. The study showed that changes in the components of endometrial secretions correlate to a decrease in secretory activity when an IUD is present. At the actual sight, a decrease in epitope was noticeable. In epithelial intracellular locations, the absence of epitope in bulk secretion in glandular lumens leads to the conclusion that there has been an impairment in the biosynthesis process. The IUD also inhibits secretory activity of endometrium. Increased copper ion concentration, although the effect on enzymes is unknown, does effect enzymatic activities such as betaglucuronidase and alkaline phosphatase. Many theories have been proposed to explain the contraceptive process of an IUD; however, the only plausible theory is one that identifies the many reactions caused by an IUD at the early reproductive stage rather than any one specific reaction. The study focuses on the endometrial response in female contraception and use of the IUD.