Duration of use of copper releasing IUDs and the incidence of copper wire breakage

Breakage of arm of Multiload intrauterine device during removal

We report a case of intrauterine device (IUD) removal five years after its insertion which was broken during the removal procedure. One of the arms of the IUD remained inside the uterus. We allowed three months for spontaneous expulsion. When this did not happen, we proceeded with a hysteroscopic removal. Because of its embebbed position in the myometrium this could not be removed during hysteroscopy and finally it was left in situ. The patient was monitored every three months for a period of 12 months. There was no problem. We report this case because doctors may find it necessary to remove the IUD in certain situations and be aware of such a breakage and various precautions to prevent this.

An analysis of the corrosion process of the Nova-T IUD

OBJECTIVE

To measure the copper from Nova-T IUDs that have been used for up to 9 years. To examine the composition and extent of surface deposits on these used IUDs.

DESIGN

Nova-T IUDs were randomly collected at normal replacement or removal. The copper, silver and calcium content was quantified by X-ray fluorescence; surface topography and analysis was by scanning electron microscopy and X-ray dispersive analysis.

RESULTS

Copper loss slowly increased at an exponential rate over the study period but the copper was stabilized by the silver core and did not show increased fragmentation with extended use. No corrosion of the silver core was detected. Calcium- and sulfur-containing surface deposits built up on the copper but did not modify the rate of copper release.

CONCLUSIONS

The mean rate of copper loss was 0.25 mumol/day during the first 40 months of use, which is not significantly different from that of similar IUDs without a silver core. The silver core of the copper coil on the Nova-T IUD prevented its fragmentation. Surface deposits containing calcium and sulfur that built up on the IUD did not affect the rate of copper loss.

The pathology of intra-uterine contraceptive devices

The IUCD is a simple and effective way of producing contraception without the need for patient compliance. It is not rendered ineffective by other drugs, as may be steroid contraceptives, and its side-effects, for carefully selected patients, are considered by most practitioners to be acceptably low (Van Kets et al. 1989).