An international multicentered clinical trial was designed to determine the possible role of intrauterine device (IUD) marker strings in the etiology of pelvic inflammatory disease (PID). A total of 1265 women were admitted and randomly allocated to receive either a standard TCu200 IUD or a TCu200 IUD without marker strings. These patients were followed-up through 12 months postinsertion. No statistically significant differences were found between the two groups of IUD users with respect to the incidence of PID or other types of infection or inflammation. The 12-month life table termination rates and overall continuation rates were also similar for users of the respective devices, with the exception of removal rates for bleeding/pain, which were significantly higher in the strings group than in the stringless group. However, the number of bleeding/pain complaints ever reported during the study were not statistically different in the two study groups. The study results indicate that the IUD string does not play an important role in the etiology of PID associated with the use of IUDs.
Some investigations of IUD use have demonstrated impaired ability to become pregnant after removal, while others have not. None of these studies, however, have adequately considered such potentially influencing variables as age and a history of pelvic inflammatory disease (PID). To study the effect of length of IUD use, IUD type and the modifying influences of age and PID history on time required to conceive, we followed women trying to become pregnant after removal of their IUD. Five hundred forty women in Ljubljana, Yugoslavia who were first fitted with an IUD between 1964 and 1972 and had their IUD removed in order to become pregnant were followed through 1980. We found no relationship between the duration of IUD use or type of IUD used, but increasing age and a history of PID each decreased the monthly probability of conception. These findings, along with other recent work, indicate that IUDs are a safe and efficacious contraceptive for women at low risk for sexually transmitted diseases.
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