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A study on the long-term effect of the intrauterine contraceptive device.


 To investigate the role of the IUD in causing neoplastic cervical or uterine change, a long-term study was carried out on 155 women at the Family Planning Clinic in the Institute of Care of Mothers and Infants (Hemayat Matharan and Koodakan Hospital) in Tehran, Iran. The patients' age ranged from 19-30 and most had borne 4 to 7 children. All were given a complete gynecological examination, and each had a normal vaginal smear before placing the IUD. The vaginal smears were repeated at intervals of 3 months, 6 months, 1 years, and every other year up to 6 years. 34 patients developed complications. 11 patients were dropped from the study because of continuous bleeding. 8 patients developed inflammatory pelvic disease and were eliminated from the study. 6 patients developed pain in the uterine region which did not respond to the regular treatment and had to discontinue use of the IUD; 4 patients expelled their IUDs in spite of multiple replacements; 5 patients suffered from discharge; 19 other patients were also dropped because of failure to attend appointments for follow-up studies and because they could not be located. 4 patients developed cervical mass lesions which were diagnosed as benign polyps. No evidence of neoplastic changes was noted in 102 patients using IUDs for a period of 6 years. The authors note that although their series and the study of Katsura et al reported in 1969 indicate that IUDs have no carcinogenic effects after 6 and 12 yrs. respectively, they are not convinced that the results would be the same if the device were used for a longer period.
