Abstract
Much has been written about the risks of PID to IUD users, but very little about the subsequent fertility status of these patients. Is tubal infertility increased in an IUD user who has been asymptomatic? Does the addition of copper make the device harmless? Was the Dalkon Shield so harmful in the nulliparous woman? Our study (89 and 90% follow-up after 12–14 years) of 200 Dalkon Shield and 142 TCu-200 users allows us to answer ‘No’ to the three previous questions. We conclude that wearing an IUDper se does not cause infertility since all our patients who had IUDs removed for intended pregnancy did become pregnant; the addition of copperper se does not make an IUD safer although it does make it more efficient; the Dalkon Shield used in nulligravidas was not more dangerous than other types of IUD.
Resumé
On a écrit beaucoup sur les risques d'infection pelvienne chez les utilisatrices de stérilets et très peu sur l'état de leur fertilité par la suite. Est-ce que le taux d'infertilité d'origine tubaire augmente chez les porteuses de stérilet qui sont asymptomatiques? Est-ce que l'ajout de cuivre rend le stérilet moins dangereux? Est-ce que le Dalkon Shield était si terrible chez les nullipares? Notre étude dont le suivi a été des plus efficaces (89 et 90% de patientes retrouvées après 12–14 ans) et portant sur 200 femmes porteuses de Dalkon Shield et 142 utilisant le TCu-200 nous permet de répondre ‘Non’ aux trois questions. Nous concluons donc que le port d'un stérilet en soi ne cause pas la stérilité puisque toutes nos patientes qui ont fait retirer leur stérilet dans le but de devenir enceinte le sont devenu; que l'ajout du cuivre ne rend pas le stérilet plus anodin mais simplement plus efficace; que le Dalkon Shield utilsé chez les nullipares n'était pas plus dangereux qu'un autre type de stérilet.
Sumario
Mucho se ha escrito sobre los riesgos de inflamación pelviana (PID) en usuarias de DIU y muy poco sobre el posterior estado de fertilidad en esas pacientes. ¿Aumenta la infertilidad tubaria en una usuaria de DIU que ha sido asintomática?. ¿El cobre agregado a un DIU lo hace inocuo?. ¿Fue tan terrible el uso de Dalkon Shield en mujeres nulípares?. Nuestro estudio (89 y 90% de seguimiento después de 12–14 años) de 200 usuarias de Dalkon Shield y 142 usuarias de TCu200, nos permite contestar ‘No’ a las tres preguntas anteriores. Concluimos que, el uso de un DIU per se no causa infertilidad puesto que todas nuestras pacientes cuyo DIU fue extraído para un intento de embarazo, quedaron embarazadas; el agregado de cobre per se no hace más inocuo al DIU sino más eficaz; el Dalkon Shield usado por mujeres nuligrávidas no fue más peligroso que otros tipos de DIU.
Similar content being viewed by others
References
EdelmanD. A., BergerG. S. and KeithL. (1982). The use of IUDs and their relationship to pelvic inflammatory disease: a review of epidemiologic and clinical studies.Current Problems in Obstetrics and Gynecology, Vol. V, No. 3, Year Book Medical Publishers, Chicago
KeithL. and BergerG. S. (1984). The etiology of pelvic inflammatory disease. InResearch Frontiers in Fertility Regulation, Vol. 3, No. 1, G. I.Zatuchni ed., Northwestern University Program for Applied Research on Fertility Regulation, Chicago, pp. 450–471
CramerD.,et al. (1985). Tubal infertility and the intrauterine device.N. Engl. J. Med.,312, 941
DalingJ.,et al. (1985). Primary tubal infertility in relation to the use of an intrauterine device.N. Engl. J. Med.,312, 937
EdelmanD., BergerG. S. and KeithL. (1979).IUDs and Their Complications, G. K. Hall & Co., Boston
Rioux, J.-E.,et al. (1986). IUD safety: a clinical evaluation.J. Can. Med. Assoc. (In press)
SandmireH. and CavanaughR. (1985). Long-term use of intrauterine contraceptive devices in a private practice.Am. J. Obstet. Gynecol.,152, 169
Sandmire, H., (1986). Fertility after intrauterine device discontinuation (In press)
BatarI. (1980). Fertility after IUD removal. In:Medicated Intrauterine Devices: Physiological and Clinical Aspects, E. S. E.Hafez and W. A. A.VanOs., eds., Martinus Nijhoff, Boston, pp. 159–168
NilssonC. G. (1982). Fertility after discontinuation of levonorgestrel-releasing intrauterine devices.Contraception,25, 273
PyoräläT., AllonenH., NygrenK.-G., NielsenN.-C. and LuukkainenT. (1982). Return of fertility after removal of Nova-T or Copper T-200.Contraception,26, 113
JainA. K. and MootsB. (1977). Fecundability following the discontinuation of IUD among Taiwanese women.J. Biosoc. Sci.,9, 137
VesseyM. P., LawlessM., McPhersonK. and YeatesD. (1983). Fertility after stopping use of intrauterine contraceptive device.Br. Med. J.,286, 106
LevinA. A., O'SheaM., SchoenbaumS. C., MonsonR. R., StubblefieldP. G. and RyanK. J. (1984). Discontinued use of intrauterine contraceptive device and pregnancy loss.Am. J. Obstet. Gynecol.,149, 768
HassonH. M. (1985). Clinical experience with intrauterine devices in a private practice.Adv. Contracept.,1, 51
NewtonW. and KeithL. (1985). The role of sexual behavior in the development of pelvic inflammatory disease.J. Reprod. Med. Suppl.,30, 82
MosherW. D. and AralS. O. (1985). Factors related to infertility in the United States, 1965–76.Sex. Transm. Dis.,12, 117
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rioux, J.E., Cloutier, D., Dupont, P. et al. Pregnancy after IUD use. Adv Contracept 2, 185–192 (1986). https://doi.org/10.1007/BF01849229
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01849229