Citation: Demir F, Desdicioglu R and Kelekci S. Assessment of -T-380A and Levonorgestrel-Releasing
Intrauterine Device Types in Terms of Partial and Complete Expulsion. Austin J Obstet Gynecol. 2014;1(6): 4.
Austin J Obstet Gynecol - Volume 1 Issue 6 - 2014
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Demir et al. © All rights are reserved
Austin Journal of Obstetrics and
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Abstract
Purpose: Intrauterine Devices (IUD) are among commonly used reversible
contraceptive methods. The aim of this study is to compare the spontaneous
expulsion rates and other factors of these two IUD types.
Material and Method: Our study was conducted retrospectively in our
hospital by recording the age, gravida, parity, IUD types; existence of expulsion,
its being partial or complete and other relevant data of the patients who received
copper IUD (Cu-T380A) and LNG-releasing IUD (Mirena).
Findings: The data of 2215 patients who used Copper IUD, and the data
of 400 patients who used LNG-Releasing IUD were included in the study.
Expulsion was detected in 234 patients (10,6%) who used Copper IUDs, and
in 34 patients who used LNG-releasing IUDs (8,5%). It was observed that the
mean age, gravida and parity values were bigger in the group who used LNG
(mean age: 34,5 ± 7,1 vs 42,47 ± 6,200, p <0,001; gravida: 2,62 ± 1,19 vs 3,04
± 1,15, p<0,001; parity: 1,96 ± 0,780 vs 2,24 ± 0,81, p <0.001). It was also
determined that the mean age values of the LNG-releasing IUD patients who
experienced expulsion were bigger than the patients with copper IUD (34,5 ±
7,1 vs 42,47 ± 6,200, p < 0.001). Moreover, the complete expulsion rate was
observed as (9 (%2,8) vs 13 (%38,2), p <0.001) in patients who used LNG-
releasing IUD.
Result: In our study it was determined that the complete expulsion rate
in LNG-releasing IUDs was more. This difference may be stemming from the
fact that the experience on using the LNG-releasing IUDs being less than the
copper IUDs.
Keywords: Contraception; IUD; Expulsion rate
Special Issue Article: Female Contraception: Types, Effectiveness, and Side Effects
Assessment of -T-380A and Levonorgestrel-Releasing
Intrauterine Device Types in Terms of Partial and
Complete Expulsion
Fatih Demir
1
*, Raziye Desdicioglu
1
and Sefa
Kelekci
1
1
Izmir Katip Celebi University, Ataturk Training and
Research Hospital, Department of Obstetrics and
Gynecology, Karabağlar, Izmir/Turkey
*Corresponding author: Dr. Demir F, Izmir
Katip Celebi University, Ataturk Training and
Research Hospital, Department of Obstetrics
and Gynecology,Karabağlar, Izmir/Turkey, Tel:
0902322434343; Fax: 0902322431530; Email:
fatihdemir28@gmail.com
Received: August 15, 2014; Accepted: October 02,
2014; Published: October 07, 2014
Austin
Publishing Group
A
Introduction
Intrauterine devices (IUD) are among the most frequently
used reversible contraceptive methods in the world. Although
the frst IUDs were produced from inert plastic, later copper IUD
and Levonorgestrel-Releasing IUDs (LNG-Releasing IUDs) were
developed [1]. Today, the copper IUDs are the most frequently used
ones in many countries. Copper IUDs have been used for many years
and their contraceptive efects have been proven to be continuing
for 12 years [2]. LNG-releasing IUDs are recommended to be used
for 5 years, and there are studies showing that they are efective for
7 years [3]. Contraceptive efect mechanisms work in various ways.
It is considered that they frstly ruin the transport of the sperms to
the oviducts and show their efects by preventing the implantation
[1,4-8]. Moreover, the LNG-releasing IUDs ruin the cervical mucus
quality with their progesterone efects [9]. Teir being efective for a
long time and being independent of patient compliance are among
their most important advantages.
Levonorgestrel Releasing-IUDs were frst used in Finland in 1990
as contraceptives. Tere are studies claiming that their contraceptive
success rates are more than the copper IUDs. However, they can have
continuance problems in patients due to their side efects depending
on progesterone secretion. Teir discontinuing rates are similar
[10-12]. Moreover, their uses in patients with heavy menstrual
bleeding, dysmenorrhea and even with adenomyosis symptoms
prevent their use as contraceptives in terms of cost-efective usage
[2,13,14]. Te side efects of both IUDs are diferent. Te most
frequent reason for discontinuation in the patients using IUD is the
pain and heavy bleeding. Te most frequent reasons for the LNG-
releasing IUDs are irregular bleedings including amenorrhea and
painful bleeding intervals. Moreover, headache, stress and qualm
that happen due to progesterone content are also observed in LNG-
releasing IUDs [10,15-18]. For copper or LNG-releasing IUDs, the
cumulative pregnancy rate is reported as being nearly 2% [19]. Te
undetected spontaneous expulsions of IUDs are closely related with
the contraceptive failure [20]. Moreover, partial expulsions may
cause symptoms like menorrhagia or pelvic pain. Te expulsion of
the former RIA, hypermenorrhea, nulliparity, young age, uterine
cavity length being less than 9 cm are reported as being the main
risk factors for expulsion [21-23]. Tere are studies that examine the
question whether there is a diference between RIA types in terms
of the expulsion rates; however, the results are various [24-26]. It is