Clinical experience with intrauterine devices in a private practice

Abstract

Clinical experience with intrauterine devices was evaluated, based on 627 insertions over a 14-year period in a private practice. Overall, there were few differences in the event rates leading to IUD discontinuation for the IUDs evaluated, principally Cu-7, Dalkon Shield and Lippes Loop. Pelvic infections were infrequent (0.7-2.2 cases per 100 woman-years of IUD use). The rate of PID in the study population appeared to be similar to that noted in the general population. IUD use did not appear to compromise future fertility, based on evaluations of patients after removal of their IUDs or from their return to fertility following IUD removal. IUD event rates (pregnancy, expulsion, displacement, removal for bleeding and/or pain) were related to the difference between endometrial cavity length and IUD length. A significant increase in the event rates was noted, regardless of the IUD type, when the endometrial cavity length exceeded IUD length by 2.0 cm or more, or when the difference between the endometrial cavity and IUD length was less than 0.5 cm.

Treatment of Kaposi Sarcoma-Associated Herpesvirus-Associated Cancers

“…Here too, high amounts of vIL-6 in the serum have been noted. This suggests excess cytokine production is one of the systemic features of MCD (Hasson, 1985). …”

Pregnancy after IUD use

“…In this study, w o m e n w h o had their IUDs removed hoping to achieve pregnancy became pregnant, as did w o m e n who had their IUDs removed for a variety of [5] as well as more recent evaluations [7][8][9][10][11] and reports that studied return to fertility if pregnancy was desired or if women discontinued their IUD use for reasons other than planned pregnancy [12][13][14][15]. Such findings do not, in our opinion, support the positions put forth by Cramer and colleagues [3] and Daling and colleagues [4] that 'IUD use per se" is associated with tubal infertility.…”

Copper IUDs, PID, and fertility in nulliparous women

“…In Hasson's clinical series [12], as noted above, all 85 women who were followed after their IUDs were removed became pregnant (two pregnancies were ectopic, and 5 ended in spontaneous abortion). In 253 women followed by van Ketz et al, 95% achieved pregnancy following Multiload removal [39].…”

“…Hasson [12] reported his experience with several IUDs during 12 years of clinical practice. Among 627 women who used IUDs, 239 women (59.7% nulliparous) used copper IUDs (Cu-7s).…”