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Accommodation defects of the intrauterine contraceptive device.


 The etiology of IUD translocation is addressed: confusion of terminology is allayed by making the following distinctions between translocation, perforation, and migration--translocation is a slow process not associated with insertion trauma; perforation is usually the result of insertion trauma but may result from translocation; and migration, which can be primary or secondary, i.e., is related to insertion procedure or a spontaneous migration related to uterine contractions. Hysterectomy specimens were used to study how linear IUDs accommodate themselves within the uterine cavity to discover the mechanism of early translocation. In addition to this experimental evidence, clinical and radiological evidence suggested that defects of accommodation of the IUD in utero lead to minimal embedding of the tip of the loop, which is theorized here to provoke migration of the device. Such spontaneous migrations seem the only way to explain the recovery of ectopic devices from remote sites.
