A Comparison of the Efficacy and Acceptability of the Copper-7 Intrauterine Device Following Immediate or Delayed Insertion After First-Trimester Therapeutic Abortion

Abstract

The incidence of untoward events in 144 women who underwent insertion of the Copper-7 (Cu-7) intrauterine device at the time of vacuum aspiration for therapeutic abortion did not differ significantly from that in 63 women who returned 33 ± 1.2 days following abortion for insertion of the device. Cramps and bleeding were no more severe following immediate postabortion insertion of the Cu-7 than following abortion only. During the 1-year follow-up period, the groups did not differ significantly in the total termination rate for medical reasons, although at 1 month postinsertion more women in the delayed-insertion group had the device removed because of pain and bleeding. There was a trend toward an increased incidence of expulsion in the immediate-insertion group. Two involuntary pregnancies occurred in the immediate-insertion group; no pregnancies were reported in the delayed-insertion group. During their one year of evaluation, 31.9% of the immediate-insertion group and 42.9% of the delayed-insertion group were lost to follow-up. The advantages of immediate postabortion insertion include the necessity for a single clinic visit for both extraction and insertion, and thus a single episode of discomfort; immediate contraceptive protection; and acceptance by a larger number of women.