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Histological and microbiological findings of endometrium caused by the use of intrauterine device (IUD) as a method of contraception.

Physicians at the Center of Family Planning at Alexandra Hospital in Athens Greece inserted IUDs in 100 women in 1986-87 and took various samples of endometrial vaginal and cervical discharge before insertion and 48-72 hours 15-18 days and 54 days after insertion to determine if a relationship exists between the IUD and intraepithelial cervical lesions or between the IUD and premalignant endometrial lesions. They removed the IUD 45 days after insertion and cultured it and performed a curettage to obtain endometrial tissue and submitted it for pathological examination. Anaerobic cultures remained negative before and after insertion. Before insertion the aerobic cultures indicated that the uterine cavity was sterile. Within 3 days after insertion however the aerobic cultures of the endometrial vaginal and cervical discharge were positive. After 10-45 days however the aerobic cultures of the endometrial discharge were negative in 98% of the women. Those of the vaginal and cervical discharge were negative in only 43% after 10-45 days. The aerobic cultures of endometrial discharge in 15% was positive several days before the IUD was removed. 15 days after IUD removal however the aerobic cultures of the endometrial discharge were again negative. Yet 45% had positive aerobic cultures of vaginal and cervical discharge after removal. Only 19% of the IUDs were positive. None of the microorganisms found were pathogenic Microorganisms in the endometrial discharge matched those in the cervical discharge. Thus the microorganisms were transferred to the uterus during insertion. The physicians did not find any a typical or malignant lesions of the endometrium or vagina.