Long-Acting, More Effective Copper T IUDs: A Summary of U.S. Experience, 1970-75

Sivin, I; Stern, Janet

doi:10.2307/1965507

Cited by 117 publications

(55 citation statements)

References 12 publications

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“…As for every Cu-IUD model [3], bleeding remains the problem to be solved if the continuation rates are to be improved significantly. Contrary to what some may have anticipated, the higher copper load on the TCu220C did not affect the risk of expulsion and this has been noted by other investigators as well [3,4].…”

Section: Discussioncontrasting

confidence: 62%

A decade of experience with the TCu220C

1985

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A decade of experience with the TCu220C has confirmed the prolonged high effectiveness, safety, and acceptability of this device. The present analysis concerns 906 interval insertions performed by three experienced operators using the retraction technique for placement of the TCu220C, and covers a total of 53,875 woman-months of experience. Gross cumulative pertinent event rates at 10 years were: pregnancy 7.5; expulsion 9.1; and removal for bleeding/pain and other medical reasons 21.9 and 9.2, respectively. Both the age and parity of the acceptor influence the long-term performance of the TCu220C.

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Section: Discussioncontrasting

confidence: 62%

A decade of experience with the TCu220C

1985

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“…Although the optimal amount for contraceptive effectiveness is known to require 200 mm2, 2 of these copper-covered shafts were introduced in the experimental horn of the rabbits so as to try to increase the amount of free dissolved copper in the oviductal milieu. The animals with one shaft showed no changes or differences in their tubal con stituents when compared to the animals with 2 copper shafts, so that adding more copper to IUDs will only extend their lives to 5 and even 10 years [4]. As might be expected, the output of fluid collected was not affected by the presence of the copper IUD and the transudation and secretion pro cesses were not impaired.…”

Section: Discussionmentioning

confidence: 57%

“…Their effectiveness results from the action of copper slowly dissolving in the uterine environment [1]. This effectiveness in time could be increased with more copper being wrapped on the shaft and the horizontal arms providing more of the copper surface [2], On the other hand, these devices did not show a substantially lower preg nancy rate [3,4], Moreover, ectopic pregnancy rates among copper IUD acceptors per 1,000 women was found to increase from 0.54 in the 1st year The present study was carried out to investigate the possible action of these copper IUDs on the oviductal milieu, their impact on the fertilization process and their possible effects on the developing zygote. The study also investigated whether an increase of the copper surface would change the chemical composition of the oviduct fluid so as to lower or suppress the rate of fertilization, thus eradicating the danger of an ectopic pregnancy.…”

mentioning

confidence: 99%

Effect of Copper Intrauterine Devices on the Chemical Composition of Rabbit Oviduct Fluid

David

Levinsky

Allalouf

et al. 1981

Gynecol Obstet Invest

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Oviduct fluid, collected from 65 mature, female rabbits in estrus and in which a modified copper intrauterine device (IUD) was introduced by laparotomy in one of the uterine horns, was examined for chemical composition. No differences were noted for sodium, potassium, calcium, chloride and bicarbonate between the two sides. The copper content was found to be significantly higher in the IUD side (12.80 ± 3.01 µg/l00 ml), as compared to the control side (9.0 ± 1.0 µg/l00 ml), the toxicity of which, to blastocyst development, has been reported in some cases. Total protein in the experimental side was significantly higher (258.52 ± 36.22 mg < 100 ml) than in the control side (156.67 ± 26.45 mg/l00 ml). The same was found for sialic acid, 5.30 ± 0,62 µg/ml, compared to 3.66 ± 0.27 µg/ml, suggesting that a part of the increased protein can be ascribed to glycoprotein. Oviduct fluid glucose was found to be lower in the copper IUD side than in the control side (10.5 ± 0.2 vs. 17.7 ± 0.3 mg/l00 ml). These findings may be explained on the basis of an inflammatory process, taking place in the side of the copper IUD, and should be used with cautiousness in adolescent, and nulligravidae women.

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“…For the implants, we estimated each year's failure rate from data on soft capsules, because these are the only ones now marketed; for the copper-T IUD, we obtained failure rates from long-term clinical trials. [2][3][4][5] We included declining failure rates for both tubal ligations and vasectomies. Pregnancies associated with these sterilization procedures occur …”

Section: Methods Effectivenessmentioning

confidence: 99%

The economic value of contraception: a comparison of 15 methods.

Trussell¹,

Lévêque²,

Koenig³

et al. 1995

Am J Public Health

205

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OBJECTIVES. The purpose of the study was to determine the clinical and economic impact of alternative contraceptive methods. METHODS. Direct medical costs (method use, side effects, and unintended pregnancies) associated with 15 contraceptive methods were modeled from the perspectives of a private payer and a publicly funded program. Cost data were drawn from a national claims database and MediCal. The main outcome measures included 1-year and 5-year costs and number of pregnancies avoided compared with use of no contraceptive method. RESULTS. All 15 contraceptives were more effective and less costly than no method. Over 5 years, the copper-T IUD, vasectomy, the contraceptive implant, and the injectable contraceptive were the most cost-effective, saving $14,122, $13,899, $13,813, and $13,373, respectively, and preventing approximately the same number of pregnancies (4.2) per person. Because of their high failure rates, barrier methods, spermicides, withdrawal, and periodic abstinence were costly but still saved from $8933 to $12,239 over 5 years. Oral contraceptives fell between these groups, costing $1784 over 5 years, saving $12,879, and preventing 4.1 pregnancies. CONCLUSIONS. Contraceptives save health care resources by preventing unintended pregnancies. Up-front acquisition costs are inaccurate predictors of the total economic costs of competing contraceptive methods.

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Long-Acting, More Effective Copper T IUDs: A Summary of U.S. Experience, 1970-75

Cited by 117 publications

References 12 publications

A decade of experience with the TCu220C

A decade of experience with the TCu220C

Effect of Copper Intrauterine Devices on the Chemical Composition of Rabbit Oviduct Fluid

The economic value of contraception: a comparison of 15 methods.

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