Abstract
The endometriums from 50 hysterectomy patient specimens were studied morphologically and biochemically to determine the effects of the IUD. 13 examples of endometrial histology were selected at different stages of the cycle to illustrate typical changes associated with the use of the IUD. 4 of the cases are presented as controls to illustrate differences between those patients using the IUD and those using no contraceptive divice. Histopathologic findings indicate that the IUD has the effect of altering the synchrony of the endometrial maturation so that the endometrium is out of phase with the ovum when and if it reaches the endometrial cavity. Further support of this idea is derived from studies on endometrial lipids. On the basis of the analysis of endometrial lipid patterns it is suggested that the presence of an intrauterine contraceptive divice arrests or retards the biochemical maturation of the endometrium. An uterine environment unfavorable to implantation results from the failure to achieve biochemical maturation of the endometrium which is synchronous to that taking place in the ovum and in other sites of the neuroendocrine system concerned with implantation. It is concluded that the effectiveness of the IUD may be the result of interference with several factors in the reproduction process.
Published Version
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