INTRAUTERINE DEVICES

Roll no. 56 - 70
Contents
- Introduction
- Mechanism of action
- Pros and Cons
- Failure rate
- Eligibility criteria
About IUDs
- Broadly there are two types of IUDs; Medicated and Non-Medicated.
- Both are usually made up of polyethylene or other polymers, in addition,
medicated or bioactive IUDs release either metal ions or hormones.
- Non medicated IUDs fall under the category of First Generation, while
copper IUDs are Second generation and Third Generation comprises of
Hormonal IUDs.
Mechanism of Action
- IUDs cause a foreign-body reaction in the uterus causing cellular and biochemical changes in
the endometrium and uterine fluids, that impairs the viability of the gamete and thus reduce
its chances of fertilization.
- Medicated IUDs, like Copper T have local effects like they enhance the cellular response in
the endometrium and also affect uterine enzymes. They also alter biochemical composition
of cervical mucus and copper ions affect sperm motility, capacitation and survival.
- Hormone-releasing devices increase the viscosity of cervical mucus and thereby prevent
sperm from entering the cervix. They also cause high levels of progesterone and relatively
low levels of estrogen, thereby rendering the endometrium unfavourable for implantation.
Advantages and Disadvantages;
PROS: CONS:

- Simple procedure, insertion takes few minutes, no - menstrual changes, heavy or excessive bleeding
hospitalisation required. - Uterine perforation
- Long lasting and very effective - Ectopic pregnancy
- Immediately reversible by removal - Expulsion
- Free of systemic metabolic side effects - No protection against STIs, HIV, PID
- Inexpensive
- Single motivation
- Copper T in comparison to other IUCDs have low
- contraindications; suspected pregnancy, PID,
expulsion rate, and lower incidences of side
vaginal bleeding of unknown etiology, anaemia,
effects
menorrhagia, history of ectopic pregnancy or
- Effective as post-coital contraceptive if inserted
PID
within 3-5 days of unprotected intercourse.
Failure rate (with reference from cdc.gov)
Levonorgestrel intrauterine system (LNG IUD)—The LNG IUD is a small T-shaped device
like the Copper T IUD. It is placed inside the uterus by a doctor. It releases a small
amount of progestin each day to keep you from getting pregnant. The LNG IUD stays in
your uterus for up to 3 to 6 years, depending on the device. Typical use failure rate: 0.1-
0.4%

Copper T intrauterine device (IUD)—This IUD is a small device that is shaped in the form
of a “T.” Your doctor places it inside the uterus to prevent pregnancy. It can stay in your
uterus for up to 10 years. Typical use failure rate: 0.8%
Eligibility criteria
According to the Planned parenthood federation of America (PPFA) has
described the ideal IUD candidate as a women:

- who has borne at least one child