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Contracept Technol Update. 1985 Jun;6(6):81-3.

New studies link IUDs, infertility; say copper devices safer.

[No authors listed]



2 studies sponsored by the National Institute of Child Health and Human Development (NICHD) report direct evidence of a link between IUDs and infertility. Both studies indicate that copper-bearing IUDs are less likely than inert IUDs to lead to infertility, but increased risk was evident for both types of IUDs. 2 of the studies' authors said the findings confirm the current practice of many clinicians to discourage women who have no children from using IUDs as their contraceptive method. 1 study involved about 90% of the infertility specialists in Seattle. Janet R. Daling, Ph.D., University of Washington School of Public Health and Community Medicine, and colleagues compared rates of IUD use in 159 childless women who had tubal infertility with an equal number of new mothers. They reached the following conclusions: using any IUD more than doubled (2.6 times) the risk of tubal infertility compared with not using an IUD; the type of IUD affected risk with Dalkon Shield users having 6.8 times the risk of tubal infertility compared with women who never used IUDs, Lippes Loop or Saf-Toil users having 3.2 times the risk, and Copper-7 or Copper-T users having 1.9 times the risk if a copper device was used at 1 time and a plastic device at another time but 1.3 times the risk if only a copper device was used; and the risk of tubal infertility for IUD users increased among women who did not have symptoms of infection as well as those who did. A 2nd larger study involved 7 infertility centers and collaborating hospitals. Dr. Daniel W. Cramer, Brigham and Women's Hospital in Boston, headed the investigation, which evaluated IUD use in 283 childless women with tubal infertility, 69 women with tubal infertility after 1 child, and 3833 new mothers. The Boston-based study found the following: overall the cumulative experience with all IUD use doubled (2.0 relative risk) the risk of tubal infertility; the type of IUD affected the risk of tubal infertility; no increased risk of infertility was apparent for women with a single sex partner; a high risk was apparent for women with a history of infection, pain, or bleeding with IUD use; and noncopper IUD users with 1 child had about 3 times the risk (2.8 relative risk) of never users of developing "secondary" tubal infertility or infertility associated with using an IUD after a 1st live birth. George Rubin, chief of the epidemiological studies branch of the Centers for Disease Control Division of Reproductive Health states that the new data confirm what has been good clinical practice for a number of years.

[Indexed for MEDLINE]

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