Ultrasonic therapy and the intrauterine device
Wheater, R.H.
JAMA 240(13): 1417
1978
ISSN/ISBN: 0098-7484 PMID: 12335436 Document Number: 128002
The Population Council received a $700,000 grant for a contraceptive leads program carried out by the International Committee for Contraceptive Research. The program, a multicountry effort, will test the effectiveness of an under-the-skin contraceptive implant, a vaginal contraceptive ring, an antipregnancy vaccine, and other products. The Program for the Introduction and Adaptation of Contraceptive Technology received $262,000 to modify contraceptive devices to fit the needs of different cultures around the world. 10 universities and research labs in 6 countries received $544,932 for basic research and training in reproductive biology. The University of California received $21,500 to study endocrine-immunological relationships during pregnancy; The University of Dublin received $95,000 to study implantation; the Institute of Biology and Experimental Medicine (Argentina) received $48,000 for research on sperm maturation; Mahidol University (Thailand) received $78,430 for research on the structure of nuclear proteins in mammalian sperm; the Clinical Research Institute of Montreal received $31,000 to study testicular factors affecting hormonal secretion; and the University of Rochester received $34,000 to study the pineal gland and reproduction. The University of Texas received 2 grants totaling $151,000 for research and training in reproductive biology; The University of Toronto received $56,000 for research on male and female reproductive tissues, and the Zoological Society of London received $30,000 to study epididymal protein secretions in the rabbit. The Ford Foundation has committed more than $225 million over the past 25 years to programs aimed at limiting fertility. Is there any evidence that therapeutic ultrasonic treatment to the lower back and abdominal areas is hazardous to a patient with a metal IUD? I found no direct evidence that customary exposure to therapeutic levels of ultrasound is harmful to a patient with a metal IUD. As you are probably aware, diagnostic ultrasound is used routinely to locate displaced IUDs, and for this application the radiation is considered innocuous. Therapeutic radiation, on the other hand, may reach levels as high as 3 W/sq cm, with exposure intervals that are protracted by comparison. Present standards only ensure that the lebel on the device accurately represents its product or, according to the Food and Drug Administration, "will assure that sufficient information on beam characteristics is supplied to allow medical personnel to make informed judgments regarding the application of ultra-sound energy." Little if any factual information is available on a situation such as you describe. There is some supposition that a projected longitudinal wave will undergo mode conversion to a transverse wave at the interface of tissue and metal with the release of energy as localized heat. The extent of such heating cannot be predicted, because each physician will vary the manner of treatment to his best judgment. It has been presumed, however, that no structural damage to tissue will occur if the temperature change is less than 10 degrees C. In summary, I suggest caution in the use of therapeutic ultrasonic treatment to the lower back and abdominal areas of a patient with a metal IUD until there is evidence on which we can base the factor of risk.