Is Copper Intra Uterine Contraceptive Device-Induced Menorrhagia Correlated with Changes in Transvaginal Ultrasound Findings before and after Insertion?

Abstract

Background: Many women all around the world use the Cu T 380A for contraception as it is cheap and effective way for contraception. Menorrhagia is the most common cause of removal of the intra uterine contraceptive device (IUCD) and it is a very annoying side effect for IUCD users. Finding a way to avoid such a complaint is important to find a proper way for contraception. Objective: To prove the correlation between the Cu IUCD-induced menorrhagia and the findings of the transvaginal Doppler ultrasound. Patients and Method: It was a prospective cross-sectional study and it was conducted on eighty four women who were referred to the family planning clinic of Zagazig University Hospital and Zagazig General Hospital for Cu T-380A IUCD insertion. The study was conducted in the period from 1/1/2019 to 30/7/2019. Then, all specimen had been classified into 2 groups:Group 1 (n =37): with menorrhagia, and group 2 (n = 47) without menorrhagia. Results: Uterine artery pulsatility index (PI) and resistance index (RI) after one month of insertion were significantly lower than at time of insertion among women with IUCD-induced menorrhagia. Endometrial thickness after one month of insertion was significantly higher than at time of insertion among women with IUCD-induced menorrhagia. PI and RI at time of insertion were significantly lower in women with IUD-induced menorrhagia than in those using IUD with normal menstrual bleeding. Uterine artery PI ≤ 1.99 and RI ≤ 0.82 have been associated with menorrhagia at time of insertion. Conclusions: The transvaginal Doppler ultrasound is very helpful in prediction of menorrhagia among IUCD users.