{
    "abstract": "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).\nIUDs perforate the uterus between 0.012% and 0.29% of insertions. Differences in operative skill and training account for the variation. Expulsion rates for copper IUDs vary from 1.8% within 2 years to 5% within 36 months. The timing of insertion tends not to affect expulsion rates. Most IUD users face heavy menstrual loss. Users of progestogen- impregnated IUDs often experience scanty menstrual loss or amenorrhea. Pain and bleeding account for discontinuation in 11-19.6 of 100 nonmedicated IUD users/year and of 4.4-6.8 of 100 copper IUD users in the 1st year of use. Irritation and pressure cause endometrial changes (e.g., a local inflammatory cell response) in most IUD users. Progestogen IUDs effect progestogen-related changes, e.g., pseudodecidualization of the stroma. Other endometrial effects of IUDs are vascular congestion and blanching and edema. Nonspecific, noninfectious cervicitis is most common in women using copper and progestogen-releasing IUDs than in women using other contraception. Candida strains are more common in the vagina of IUD users than in controls (20% vs. 6%). 2.8-11.6% of cervical smears of IUD users with no predisposing factors show Actinomyces-like organisms. Even though some studies suggest that IUDs increase the risk of pelvic infection, the increase occurs only in the first few months after insertion. There is also an increase for women with multiple partners. Less than 1% of IUD users become pregnant. About 50% and 25% of these women experience spontaneous abortion, if the IUD is left in situ or immediately removed, respectively. IUD users are at increased risk of ectopic pregnancy (5- 7.8% of pregnancies). Copper IUDs have the lowest ectopic pregnancy risk, while the low dose progestogen IUDs have the highest. Assuming no pelvic infection, fertility returns after IUD removal (e.g., 96.7% become pregnant within 18 months). Nulligravida who have ever used an IUD are 2-2.6 times more likely to have primary tubal infertility than those who had never used an IUD.",
    "authors": [
        {
            "affiliation": "Department of Gynaecological Pathology, St. Mary's Hospital for Women and Children, Whitworth Park, Manchester, UK.",
            "firstname": "C H",
            "initials": "CH",
            "lastname": "Buckley"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.1007/978-3-642-76846-0_8",
    "journal": "Current topics in pathology. Ergebnisse der Pathologie",
    "keywords": [
        "Biology",
        "Cervix",
        "Contraception",
        "Contraceptive Effectiveness",
        "Contraceptive Methods--side effects",
        "Demographic Factors",
        "Diseases",
        "Endometrial Effects",
        "Endometrium",
        "Family Planning",
        "Fertility",
        "Genitalia",
        "Genitalia, Female",
        "Histology",
        "Infections",
        "Insertion",
        "Iud Expulsion",
        "Iud--side effects",
        "Literature Review",
        "Pelvic Infections",
        "Physiology",
        "Population",
        "Population Dynamics",
        "Pregnancy Complications",
        "Pregnancy, Ectopic",
        "Treatment",
        "Urogenital System",
        "Uterus",
        "Vagina"
    ],
    "methods": null,
    "publication_date": "1994-01-01",
    "pubmed_id": "8162713",
    "results": null,
    "title": "The pathology of intra-uterine contraceptive devices.",
    "xml": "<Element 'PubmedArticle' at 0x788506f5bab0>"
}