Clinical Experience with the Copper 7 Intrauterine Device

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William A. Nebel, M.D. John L. Currie, M.D. Richard E. Lassiter, M.D.

Chapel Hill Obstetrics and Gynecology, P.A., Chapel Hill, North Carolina 27514

Fertility and Sterility Journal
November 1978

This paper reports further observations on our previous study of 203 Copper 7 intrauterine insertions performed in 199 women. There have now been accumulated 3 799 woman-months of use. At least a 2-year period of observation has been attained from first insertion until these data were analyzed. The Copper 7 intrauterine device (IUD) continues to be an acceptable contraceptive method with regard to effectiveness, continuation, and lack of serious complications. Those patients who elected to have their copper 7 IUDs removed for planned pregnancy were also analyzed with regard to fertility capacity. Possible complications with the need to change the copper 7 IUD and risk of prolonged use were not verified. There was a decrease in contraceptive effectiveness after 12 more months' use.

Excerpts from Abstract

Nebel and associates reported their preliminary clinical experience with the Copper 7 intrauterine device (IUD). There were favorable results regarding effectiveness, continuation, and lack of serious complications. Several caveats were raised, such as future fertility, risk with more prolonged use, potential problems with the need to change the intrauterine device after 2 years' use, and contraceptive effectiveness with longer use. Our experience now allows comment on these queries.

RESULTS
A total of 3799 woman-months of use has been accumulated. All active patients using the Copper 7 IUD have had at least 24 months' experience with the Copper 7 IUD except for the 33 patients (16%) lost to follow-up. … increase in the accidental pregnancy rate (from 1.6% to 3.7%) with the addi-tional 12 months ofiUD use. ….. decrease in expulsion rate from 12.2% to 5.3%. …..Unacceptable uterine bleeding remains an infrequent cause of all removals (15% in this study and 27% in the earlier study). ….. total of three patients with clinically suspected salpingitis……..Earlier in the study we recommended IUD re-moval after 2 years' use because of our under-standing that longer use was associated with lower contraceptive effectiveness…….Fourteen of nineteen patients (74%) successfully conceived. All experienced normal term pregnancies resulting in healthy babies……There were no premature deliveries,

DISCUSSION
With an additional 12 months' use of the Cop-per 7 IUD, we have noticed a slightly greater risk of accidental conception (1.6% increased to 3.7%)…….. The 68.4% continuation rate at 2 years is demonstration of patient acceptance. This rate compares favorably with the continuation rates reported by Measham and Villegas at 24 months for the TCu-200 (58%), the Lippes Loop (52%), and the Dalkon Shield (40%)……

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Fertility and Sterility Journal
ASRM: American Society for Reproductive Medicine