Important factors in the use-effectiveness of the copper-T-200 IUD

Akinla, Oladele; Luukkainen, Tapani; Timonen, Henri

doi:10.1016/s0010-7824(75)80052-7

Cited by 10 publications

(7 citation statements)

References 15 publications

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“…Additionally, two prospective cohort studies provided evidence on continuation rates over 12 months by timing of IUD insertion. In one, continuation rates were highest among those with insertion during menses or immediately thereafter [4]; however, no statistical comparison was reported. In the other, rate of continuation did not differ by timing of insertion [5].…”

Section: Discussionmentioning

confidence: 91%

“…After reviewing the titles and abstracts of these articles, as well as the full articles when necessary, eight articles met our criteria for inclusion in this review (Table 1) [4][5][6][7][8][9][10][11]. No systematic reviews were found from the search of the Cochrane database.…”

Section: Resultsmentioning

confidence: 99%

“…Four cohort studies examined the effects of Cu-IUD insertion at different times during the menstrual cycle on rates of continuation, removal, expulsion, and/or pregnancy [4,5,9,10]. A study of 9904 women found that rates of expulsion in the first two months post-insertion were highest among women with insertions on Cycle Days 1-5 (50.3 per 1000), with rates decreasing to 30.5 for insertion on Cycle Days 6-10, 24.0 for insertion on Cycle Days 11-17 and 22.0 for insertions on Cycle Day 18 or later (p<.0001 for trend) [10].…”

Section: Resultsmentioning

confidence: 99%

“…A second study examined a cohort of 2536 women and found that continuation rates were highest among those who underwent insertion during menses or immediately thereafter [4] A third cohort study examined 867 women with IUD insertions occurring during or after menses and found that over 12 months, rates of continuation, expulsion, removal and pregnancy did not differ by timing of insertion (p>.10) [5]. A fourth cohort study examined 615 women, including 156 HIV-positive women and 493 HIV-negative women, and found that over four months, those with insertions during menses had similar rates of expulsion, removal and pelvic inflammatory disease (PID) as those with insertions outside the menses, although direct statistical comparisons were not reported [9].…”

Section: Resultsmentioning

confidence: 99%

“…Rates of expulsion and rates of removal in relation to timing of Cu-IUD insertion were examined in four prospective cohort studies [4,5,9,10], while one nested case-control study examined the association between IUD expulsion and timing of IUD insertion [11].…”

Section: Discussionmentioning

confidence: 99%

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When can a woman have an intrauterine device inserted? A systematic review

et al. 2013

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Background-Intrauterine device (IUD) insertion during menses may be viewed as preferable by some providers, as it provides reassurance that the woman is not pregnant. However, this practice may result in unnecessary inconvenience and cost to women. The objective of this systematic review is to evaluate the evidence for the effect of inserting IUDs on different days of the menstrual cycle on contraceptive continuation, effectiveness and safety.Study Design-We searched the MEDLINE database for peer-reviewed articles published in any language from database inception through March 2012 concerning the effect of inserting copper IUDs (Cu-IUD) or levonorgestrel-releasing IUDs (LNG-IUDs) on different days of the menstrual cycle on contraceptive continuation, effectiveness, and safety. The quality of each individual piece of evidence was assessed using the United States Preventive Services Task Force grading system. Results-We identified eight articles that met the criteria for review. Each study examined the Cu-IUD; no studies were identified that examined the LNG-IUD. Overall, these studies suggest that timing of Cu-IUD insertion has little effect on longer term outcomes (rates of continuation, removal, expulsion, or pregnancy) or on shorter term outcomes (pain at insertion, bleeding at insertion, immediate expulsion). Specifically, there was no evidence to suggest that outcomes were better when Cu-IUD insertions were performed during menses. Limitations of the studies include small sample sizes for insertions performed during later days of the menstrual cycle and non-randomized assignment to timing of insertion.Conclusions-There is fair evidence (body of evidence grading: II-2, fair) indicating that timing of Cu-IUD insertion has little effect on contraceptive continuation, effectiveness or safety.

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Section: Discussionmentioning

confidence: 91%