Abstract
This study was undertaken to investigate the role of cytokines in intrauterine contraception. Cervical mucus samples were obtained from 20 women with proven fertility 7, 14, 30, and 120 days after insertion of copper-T380 intrauterine devices (IUDs) for the determination of interleukin-2 (IL-2) soluble receptor (IL-2SR) and granulocyte macrophage colony stimulating factor (GM-CSF) concentrations. Both levels of IL-2SR and GM-CSF were significantly elevated after insertion of copper-releasing IUDs. This elevation remained significant through 6 months post-insertion. The mean-fold rise of GM-CSF compared to pre-insertion mean values amounted to 12.4, 11.8, 2.1, and 1.5 at 7, 14, 30, and 120 days post-insertion, respectively. The corresponding values for IL-2SR were 10.4, 8.8, 2.6, and 2.5, respectively. These results demonstrate enhanced local cytokines production in IUD users indicating local inflammatory reaction in the endometrium. This inflammatory reaction together with the cytotoxic effects of these cytokines may produce an environment which adversely affect embryo pre-implantation. This may explain the antifertility effect of copper IUDs.
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