Return of Fertility after the Removal of Intrauterine Devices: A Comparison of Inert and Copper Bearing Devices

Abstract

The use of intrauterine device (IUD) has been suspected to be linked to involuntary infertility due to increased risk of pelvic inflammatory diseases. Nevertheless, it remains unclear whether the overall risk of infertility after discontinuing use of IUD increases with the duration of IUD use. Thus, the present study was designed to evaluate the return of fertility after discontinuing use of copper containing IUDs compared to inert IUD and to determine a possible relationship between the length of IUD use and return of fertility. Ninety women with Lippes Loop type D (LL), 88 women with Copper-T200 (TCu-200) and 83 women with Multiload Copper-250 (MLCu-250) were included in the analysis. The life table analysis and log rank-test showed that TCu-200 and MLCu-250 acceptors had a more rapid return of fertility compared to LL acceptors, although there was no significant difference in the return of fertility between TCu-200 and MLCu-250 acceptors. Compared to LL acceptors, the net cumulative probability of pregnancy after discontinuing use of IUD was 3 times higher in copper containing IUD acceptors in the first 3 months and somewhat higher in the first 4 to 11 months after removal of IUD. The length of use in copper containing IUDs (TCu-200 and MLCu-250) acceptors did not influence the return of fertility, whereas the return of fertility after removal of inert IUD (LL) was significantly higher in case of the use for shorter than 48 months compared to the use for longer than 48 months.(ABSTRACT TRUNCATED AT 250 WORDS)