Intrauterine contraceptive device (IUD)

Posted by e-Medical PPT Monday, November 8, 2010
Intrauterine contraceptive device (IUD) is a form of birth control that involves an object placed in the uterus to prevent fertilization of the egg by sperm and inhibit tubular transport.
Types include:
    * IUD with copper
    * IUD with progestogen
American Journal of Obstetrics and Gynecology stated that "although prefertilization effects are more prominent for the copper IUD, both prefertilization and postfertilization mechanisms of action contribute significantly to the effectiveness of all types of intrauterine devices"; and "the major postfertilization effect is destruction of the early embryo in the Fallopian tube.
The IUD with progestogen or intrauterine system (IUS) is a long-acting reversible hormonal contraceptive device that is placed in the uterus. An IUS has a hormone cylinder that releases a progestin (a synthetic progestogen) called levonorgestrel.
The IUS can only be fitted by a qualified medical practitioner. The device should be inserted according to the manufacturer's instructions using aseptic technique to avoid introduction of bacteria into the uterus. Antibiotics should be given before insertion to women at high risk for endocarditis (inflammation of the membrane lining the heart), but should not be used routinely.
During the placement appointment, the cervix is dilated in order to measure the uterus and insert the IUS. Cervix dilation is uncomfortable and, for some women, painful. Doctors often advise women to take painkillers before the procedure to reduce pain and discomfort, and some may even use a local anaesthetic. Insertion may be more comfortable if done midcycle, when the cervix is naturally dilated.
Once in place, the IUS is approved for birth control for up to 5 years. The cumulative 5-year pregnancy rate is estimated to be 0.7%

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