Use of Copper Intrauterine Devices and the Risk of Tubal Infertility among Nulligravid Women. (Sex Research Update)
McKay, Alexander, The Canadian Journal of Human Sexuality
Hubacher, D., Lara-Ricalde, R., Taylor, D.J., Guerra-Infante, F., & Guzman-Rodriguez, R. (2001). Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women. New England Journal of Medicine, 345, 561-567.
It has long been believed that intrauterine devices (IUDs) cause pelvic inflammatory disease (PID) and subsequently lead to tubal infertility. Studies that indicated an association between IUDs and PID lead to the withdrawal of many IUDs from the North American market. In particular, one IUD, the Dalkon Shield, was shown to be strongly associated with PID. Less than 5% of women of reproductive age in Canada and the United States use IUDs but they are commonly used in Asia and Europe. As Hubacher et al. point out in the introduction of their research report, studies assessing the association between IUDs and PID have been controversial and produced inconsistent findings. The primary objective of the Hubacher et al. study was to assess the association between the previous use of a copper IUD and tubal occlusion.
The authors conducted a case-control study of 1895 women recruited from 3 hospitals in Mexico City. The sample was divided into three groups: infertile women with tubal occlusion, infertile women without tubal occlusion (infertile control group), and primigravid women (pregnant controls). Study subjects provided a range of information including sexual behaviour, contraceptive use, including copper IUDs, and history of STD. …