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Ectopic pregnancy despite intrauterine contraception: a clue to mode of action of I.U.C.D.s.

103 patients who were admitted to the hospital with ectopic pregnancies 14 who had conceived with an IUD in place were studied. Laparotomy or laparoscopy revealed the pregnancies to be located in the ovary the tubal infundibulum and the tubal ampulla. These findings may indicate something about the mode of action of IUDs. They do not prevent ovulation or sperm invasion of the oviducts. They reduce uterine pregnancy by 99.5% and tubal pregnancy by 95% but do not interfere with ovarian nidation. IUDs do not inhibit normal fertilization but may disturb ovum migration along the Fallopian tube resulting in more tubal implantations when contraception fails.