Abstract

PIP: Intrauterine plastic loops were inserted 2179 times into 1713 patients of the Planned Parenthood Center of Buffalo, New York and from the author's private practice between November 1, 1961 and June 30, 1964 to evaluate the acceptability, effectiveness, reversibility, and side effects of this contraceptive method. Median age of the patients was 26 and their median parity 3. At the Planned Parenthood Center, patients are offered a choice of oral contraception (OC), condoms, diaphragms, jellies, rhythm, and the loop. During 1962, 30% of the new patients chose the loop. In 1963, 48% of new patients chose intrauterine contraception, and this proportion continued through June 1964. It rose to 55% early in 1965. 41 pregnancies occurred giving an overall pregnancy rate of 2.2/100 woman years for all loops. Loop D had a rate of 1.0/100 woman years. The pregnancy rate was calculated according to Potter's life table procedure. These rates compared favorably with a diaphragm failure rate of 4/100 woman years reported in the Indianapolis study or the diaphragm failure rate of 14.4 reported by Westoff and Potter, as well as with the rate of 2.1 for OC reported by Cook, Gamble, and Satterthwaite. 23 patients became pregnant with a loop in situ. There were 20 loop failures where location of the device was undetermined. Before November 30, 1964, 32 patients had discontinued intrauterine contraception because they wanted a child. All but 3 became pregnant. There were no abortions. The devices are not tolerated by all patients. Side effects consisted primarily of expulsions and bleeding, but pain and the possibility of infection were sometimes present. The monthly expulsion rate decreased with continued use. Most expulsions occurred in the 1st 6 months of use, and the largest and heaviest device had the lowest expulsion rate. 90% of the patients exhibited some alteration of their menstrual pattern. Cramps or pain were only a minor reason for terminating intrauterine contraception. Other side effects included fainting. Subsequent contacts made with 94% of those who had worn their loop for 1 or more months revealed that 23 patients had tentative diagnoses or histories of pelvic inflammatory disease. Endometrial biopsies and Papanicolaou smears gave no evidence that the method induced carcinoma.