Fifteen years' experience with the Multiload IUD

Abstract

The Multiload IUD with an exposed copper surface area of 250 mm2 (MLCu250) was developed in 1972 and has become one of the most widely used IUDs. Modifications to the MLCu250 include an increase in the area of exposed copper wire to 375 mm2 (the MLCu375) and an increase in the diameter of copper wire from 0.3 to 0.4 mm. The Multiload has been evaluated extensively in noncomparative and comparative clinical trials. In these latter studies the MLCu250 performed better than the Cu-7 and TCu-200, and the MLCu375 performed better than the Fincoid or Nova T and about equally as well as the TCu380. Pooled data from over 26,000 insertions of the MLCu250 gave the following 3-year cumulative event rates (per 100 women): pregnancy, 2.0; expulsion, 3.1; removal for pain/bleeding, 7.1. Comparative studies of the Multiload and other IUDs have shown all IUDs in current use are associated with similar rates of pelvic inflammatory disease. IUDs such as the MLCu375 that have larger copper surface areas appear to be associated with lower ectopic pregnancy rates. Follow-up studies of women who have had their Multiloads removed indicate that use of the device does not impair future fertility or affect pregnancy outcome. All IUD users, regardless of the type of IUD used, are at risk of complications. On balance, the benefits of IUD usage far exceed the associated risks.

Long-term experience with Multiload intrauterine devices

“…during the very cycle the device was removed. These results are not different from those reported by other investigators [15][16][17][18][19][20].…”

“…Bleeding and/or pain. As in other large-scale studies [20] bleeding was the main indication for discontinuation of the method and 115 terminations were based upon bleeding alone and 42 on combined bleeding and pain. Pain accounted for 45 removals of the IUD (Table 2).…”

An evaluation of six new intrauterine devices

“…The original MLCu375 IUDs, which are currently used worldwide (and were also developed by Van Os), have demonstrated impressively low termination rates (i.e. pregnancy, expulsion and medical removal for bleeding and/or pain), which are similar to or only slightly higher than those with the TCu380A/Ag IUD [11]. However, as the device is inserted with both arms outside the inserter tube, difficulties in insertion have been reported.…”

Safety of intrauterine contraception

“…In a review of comparative studies of the Multiload [10], the PID rates for this device based on 3181 insertions in 5 studies ranged from 0.0 to 2.8%. For the comparative IUDs in these studies, PID rates ranged from 0.0 to 4.3%.…”