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Consideration of the relationship between the compliance of some intrauterine contraceptive devices and the expulsion rates (first).

This study reexamined the relationship between the compliance (pliability) of several intrauterine contraceptive devices (IUCDs) and the rates of first expulsion. Others had measured the stiffness of several devices by determining the force needed to straighten the IUCD. Those making these measurements reported that the stiffest device had the lowest expulsion rate. The author used a precision scale which determined the amount of force needed to reduce the IUCD to half its lateral dimension which measured transverse bend stiffness. (The other method measured longitudinal stiffness). In contrast to the previous findings expulsion rates were higher for stiffer devices and lower for devices with greater pliability. Association with expulsion rates was independent of size of the device although size of loops of the same device made some difference. The mechanism of expulsion remains unclear. Measurements of compliance must be at least bi-directional. Shape surface area material and design are other variables to be considered in use-effectiveness and in redesigning IUCDs.