Long-term use /use beyond recommended time
ESC Congress Library. Batar I. May 1, 2008; 2075 Disclosure(s): Financial support: none received. Conflict of interest: nil.
Prof. Istvan Batar
Prof. Istvan Batar
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Introduction Although there had been anecdotal cases about women who wore their forgotten Gräfenberg ring through decades, at the beginning of the new era of intrauterine contraceptive device (IUD) in the 1960s even the plastic IUDs were suggested to be replaced in relatively short periods (e.g. one year). Parallel with the increasing clinical experiences the officially accepted lifespan of devices gradually extended, and by now the longest FDA-approved period is 13 years for TCu-380.
Material The IUD database of the Family Planning Center, University of Debrecen, Hungary accumulated more than 47,000 insertions between 1972 and 2006. This enabled the author to reinvestigate the question, and to draw reliable conclusion on the long term use of device even beyond the presently recommended time.
Results The presentation summarizes the result of 37,758 cases (18,075 with non-medicated devices = Group I. and 19,683 with copper-containing IUDs = Group II.), which represents a total of 179,139 woman-years of use (95,565 and 83,573 years, respectively). At the end of the 20th year of continuous use (without changing device) the number of those at risk was 503 (2.8%) in Group I. and 216 (1.1%) in Group II. Gross cumulative life table rates and specific (annual) Pearl-indices were calculated for the related terminations (pregnancy; expulsion; removal for bleeding/pain, other medical reason, planned pregnancy and other personal reason).
Conclusion Based on the results, it is stated that even the copper containing devices may be left in situ up to twenty years if the user has no problems, and the routine yearly follow-ups show no alterations.
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