Effects of intrauterine devices on the surface ultrastructure of human endometrium before and after removal.

The effects of copper-releasing IUDs on the endometrial ultrastructure were evaluated in 101 women. Endometrial samples were obtained in the secretory phase of the menstrual cycle, both during and after IUD use, and were evaluated using both scanning and electron microscopy. The degree and extent of changes to the surface ultrastructure of the endometrium were found to be related to the copper surface area of the IUD.

Contraception for women exposed in utero to diethylstilbestrol.

Although the effects of in utero exposure to diethylstilbestrol (DES) have been extensively documented, there is an absence of information on the suitability of different contraceptives for use by DES-exposed women. This paper briefly describes some of the effects associated with DES exposure. Use of various contraceptive methods by DES-exposed women are considered in light of these effects.

Medical removals of the Multiload IUD.

In a follow-up evaluation of 3721 Multiload IUD users, the removal rate for medical reasons other than bleeding/pain was only 2.6 per 100 women at three years. Most of these removals were for reasons that appeared to be unrelated to IUD use.

The future of intrauterine contraception.

In this review paper some guidelines for IUD use are presented that if followed should reduce the incidence of IUD-related complications. Recent IUD developments are discussed including the levonorgestrel-releasing T, a new variation of the Multiload, and IUDs designed for postpartum insertion. Since significant improvements in IUD safety will most likely result from a better understanding of IUD-related side-effects and adverse reactions, the paper includes recommendations for future IUD research that could enhance the safety, effectiveness and acceptability of available IUDs.

Mechanism of action of IUDs: an ultrastructural view.

Endometrial samples from 64 women using different types of IUDs were used to study the ultrastructural changes of the human endometrium as influenced by nonmedicated and copper devices, using SEM and TEM in an attempt to explain the physiological mechanism of their actions. The absence of cytoplasmic macro-apocrine secretory granules with copper devices and their defective separation with nonmedicated IUDs support the theory that the IUD interferes with the carbohydrate metabolism and secretory function of the endometrial cells. It also indicates that IUDs may function through the interference with the blastocyst-endometrial interaction and blastocyst survival.

Ultrastructural changes in human endometrium with copper and nonmedicated IUDs in utero.

Scanning and transmission electron microscopy were used for a study of the surface and glandular ultrastructure of human endometrium in the presence of different types of IUDs at comparable phases of the menstrual cycle. The aim of the study was to compare the effect of the nonmedicated with the copper and multiload copper devices to further explain the differences in their contraceptive potencies and their mechanism of action. The endometrium was evaluated at and away from the IUD; emphasis was put on the ultrastructure of endometrial gland openings, secretory activity, cellular glycogen content, ciliated cells, microvillous pattern, and kinocilia.