Cervical and endometrial cytology associated with wire breakage and copper loss in copper IUD wearers

Abstract

Intensity of breakage in the copper wire and amount of copper lost from the CuT200 lUDs have been estimated in 176 women who have worn the device for periods ranging from 1 to 10 years. The copper loss corresponded with breakage in wire mainly in the moderate and severe breakages. A progressive increase in copper loss was seen with increasing contraceptive use, with mild loss observed optimally at 3 years, moderate at 4 years and high copper loss at 6 years. The cytological evaluation of cervical smears and endometrial aspirates revealed a high incidence of pathology both in the cervix and endometrium with high copper loss and also following replacement of the original device with a second one. The accumulated data thus points to some relation between amount of copper released from the lUDs and precancerous manifestations in the epithelia of upper female genital tract. Further, need for constraint was felt in motivating women of high age and parity against CuT contraception, as high copper loss was mostly seen in this category.