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Higher-Dose Copper IUDs Provide Better Pregnancy Protection

Intrauterine devices that contain higher doses of copper are more effective in preventing pregnancy than IUDs with lower copper doses, according to a new systematic review// of studies.

In addition, increasing the copper content does not cause an increase in side effects prompting removal of the device, such as bleeding and pain, the review found.

“In general, the comparative analyses suggest higher effectiveness and similar side effect profile with high-copper IUDs compared to low-copper ones,” concluded the review authors.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

The IUD is the most widely used reversible method of contraception in the world. Most IUDs consist of a plastic frame wrapped with copper wire, although the shape of the frame and the amount of copper wire vary among models.

The reviewers analyzed 34 randomized controlled trials that compared the effectiveness and side effects of different copper IUDs. More than 50,000 women from around the world were enrolled in these studies, which lasted from one year to 12 years.

Nine IUDs were included in the analysis. Most devices had a T-shaped or horseshoe-shaped design. The surface area of copper varied from 200 to 380 square millimeters.

According to the reviewers, the most well-studied IUD in these trials, the T380A, was also the most effective in preventing pregnancy. The TCu380A is the only copper IUD approved for use in the United States.

The T380A, sold under the trade name ParaGard, is a T-shaped device that contains 380 square millimeters of copper, the highest dose of all IUDs included in this analysis. In dir
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