Intrauterine contraceptive device — status report

Effective inhibition of the early copper ion burst release with ultra-fine grained copper and single crystal copper for intrauterine device application

To solve the main problems of existing coarse grained copper (CG Cu) intrauterine devices (IUD)-namely burst release and a low transfer efficiency of the cupric ions during usage-ultra-fine grained copper (UFG Cu) and single crystal copper (SC Cu) have been investigated as potential substitutes. Their corrosion properties with CG Cu as a control have been studied in simulated uterine fluid (SUF) under different conditions using electrochemical measurement methods. Long-term immersion of UFG Cu, SC Cu and CG Cu samples in SUF at 37 °C have been studied for 300 days. A lower copper ion burst release and a higher efficiency release of cupric ions were observed for UFG Cu and SC Cu compared with CG Cu in the first month of immersion and 2 months later. The respective corrosion mechanisms for UFG Cu, SC Cu and CG Cu in SUF are proposed. In vitro biocompatibility tests show a better cellular response to UFG Cu and SC Cu than CG Cu. In terms of instantaneous corrosion behavior, long-term corrosion performance and in vitro biocompatibility, the three pure copper materials follow the order: UFG Cu>SC Cu>CG Cu, which indicates that UFG Cu could be the most suitable candidate material for intrauterine devices.

Comparative cost-effectiveness of three intrauterine devices: a multi-center randomized trial

OBJECTIVE

To determine the relative cost-effectiveness of three intrauterine devices (IUDs), MLCu375, TCu380A, and YuangongCu365.

METHODS

Cost-effectiveness of three IUDs, namely MLCu375, TCu380A, and YuangongCu365, was analyzed from the provider's perspective by means of a randomized trial with one-year follow-up carried out in six centers in China.

RESULTS

YuangongCu 365 had the lowest termination and pregnancy rates (4.17% and 0.54%, respectively), followed by TCu380A (8.59% and 1.11%, respectively) and MLCu375 (14.17% and 2.04%, respectively). YuangongCu365 was more effective yet more costly than the MLCu375. There was a favorably dominating trend of cost-effectiveness for TCu380A comparing with MLCu375 when taking continuation rate as the effectiveness indicator, but there was no difference in cost-effectiveness between the two IUDs when using the pregnancy avoidance rate as the effectiveness measure.

CONCLUSIONS

TCu380A is slightly more cost-effective than the MLCu375. YuangongCu365 is the most effective of the three devices and be used provided it is economically affordable. The comparative long-term safety and cost-effectiveness of these devices need to be further investigated.