Effects of ML Cu 250 IUD on the endometrium and sperm migration together with clinical results
Koch, U.J.; Vogel, M.
Contraceptive Delivery Systems 1(1): 37-48
1980
ISSN/ISBN: 0143-6112 PMID: 12261716 Document Number: 445528
During the last 3-year period 540 M1 Cu 250 IUDs have been inserted as part of a family planning counseling scheme in Berlin. 51% of the women were nulliparae; 40% had primary or secondary menstrual disorders. The net cumulative termination rates per 100 women (n=351) were calculated by life-table analysis according to Tietze et al. The pregnancy rate was 0.3 after 18 months and 1 after 24 months. 88% of the women (n=208) showed a normal cytology of the uterine cervix and in 11.5% there was an inflammatory cell reaction. In most of the cases the endometrium (n=40 biopsy specimens) showed an inflammatory reaction of a weak nature consisting essentially of a cellular reaction with a partial cell infiltration of the surface epithelium. The accompanying reaction was a weak edema of the stroma with a slight broadening of the capillaries. Cyclic development of the endometrium was disturbed in 50% of the cases. Although there was a negative influence on sperm migration at the time of ovulation, the migration was not totally blocked. There was excellent migration in some cases in the Kremer sperm penetration test (n=50) when there was a large number of leukocytes in the cervical mucus. The peritoneal sperm migration test was negative in all of the cases (n=10). The increase in the proportion of granulocytes, plasma cells, lymphocytes and macrophages in the endometrium and in the uterine section, with no pathological bacterial invasion, demonstrates a reaction of the endometrium to a foreign body and not an inflammation caused by an infection. Sperm migration disturbances can be regarded as a partial effect in the multi-factorial mode of action of the ML Cu 250 IUD.