Analysis of surface deposits on intrauterine contraceptive devices

Abstract

Surface deposits on stainless steel contraceptive devices removed from the uterus after varying periods of insertion were examined and analyzed by means of scanning electron microscopy (SEM), X-ray energy dispersive analysis (XEDA), Augar electron spectroscopy (AES), X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM) and atomic absorption spectrophotometry for microquantitative analysis. The data obtained were compared with the data for copper-bearing IUDs (TCu200) obtained by the same method. The wire coils of stainless steel IUDs which had been in situ for 5 years showed no obvious changes, but copper wire coils showed varying degrees of erosion after the same period of time. Analysis clearly showed that the wire coils of both types of IUD were encrusted with deposits. Deposition began earlier on copper-bearing IUDs than on stainless steel IUDs (27 days and 3 months after insertion, respectively). This process began earlier than has previously been reported in the literature. The amount of deposit increased with duration of insertion, but there were large individual variations. The microanalysis showed that the principal component of the deposit on both types of IUD was calcium, which was present in the crystal form of calcium carbonate. The substances attaching to the crystals were similar to the nitrogenous organic compounds. We suggest that the mechanism regulating the deposited formation may be similar to that of calculus. The influence of these deposits on complications relating to IUD insertion, such as uterine bleeding and accidental pregnancy, is briefly discussed in this article. The subject should be studied in greater detail.

A 20-Year-Old Contraceptive Device Transformed into a Calcified Mass

“…Once perforation has occurred, damage has been described to most pelvic organs. Surface deposition on IUCD occurs in a linear manner with time [2] with changes detectable on electron microscopy within three months of insertion; deposition on copper containing devices occurs significantly sooner than that on inert devices [3]. Extensive encrustation as in this case has not been previously reported and is particularly unusual with the IUCD subsequently acting as a focus for calcification although no convincing evidence of vesico-vaginal fistula was ever demonstrated.…”

“…Risks of neglecting an IUCD include migration, infection and calcification. A case of IUCD calcification, with an unusual presentation as a possible vesico-vaginal fistula is described and discussed [1]- [3].…”

Corrosion characteristics of copper‐based IUDs

“…This limits the effectiveness of the IUD by lowering service life of the device and by causing adverse side effects for IUD users (uterine bleeding, uterine perforation risks and accidental pregnancy) (Chantler et al, 1984;Yuan et al, 1986). Corrosion products had a tendency to form passive layers (i.e.…”

“…Because corrosion limits the efficiency and time of use of the device, some studies have focused on the rate of copper release in vivo and in vitro (Bastidas and Simancas, 1997; Kjaer et al , 1993; Kosonen and Thiery, 1983; Thiery and Kosonen, 1987; Timonen, 1976). Generally, two events of the copper degradation (mainly wire fragmentation) in uterus are accepted: first the accelerated release of copper by the influence of pH and deposition of corrosion products (Bastidas et al , 2000, 2001; Mora et al , 2000; Yuan et al , 1986), and secondly the deposition of proteins, anti‐inflammatory agents, blood, cell debris and calcification (Rizk et al , 1990; Valdez et al , 2000; Xue et al , 1998; Zhu et al , 1999). The oxygen concentration dissolved in the uterine fluid is another factor that affects the rate of IUD degradation due to copper corrosion.…”

A 20-year-old contraceptive device transformed into a calcified mass

“…Perforation of the uterine fundus is the most common problem (1). Surface deposition on IUCD occurs in a linear manner with time (2); deposition on copper-containing devices occurs significantly sooner than on inert devices (3). Extensive encrustation as in this case has not been previously reported and is particularly unusual with the IUCD subsequently acting as a focus for calcification although no convincing evidence of vesico-vaginal fistula was ever demonstrated.…”