ect comparisons, it performed as well as or better than both lower-dose T-shaped IUDs and horseshoe-shaped IUDs containing up to 375 square millimeters of copper.
The one-year pregnancy rate for the T380A was 0 to 1 percent across the 17 trials in which it was studied. In comparison, the one-year pregnancy rate with the TCu200, which contains 200 square millimeters of copper, was 0 to 6.2 percent across the seven trials in which it was studied.
“It is unlikely that new IUDs will be much more effective than TCu380A in short-term use,” the authors said. “Contending IUDs will need to be studied in large number over a long period of time.”
“Women in [the United States] who want long-term contraceptive protection are lucky that they have the best-performing copper IUD in the world,” said David Hubacher, Ph.D., senior epidemiologist at Family Health International.
The most common side effect leading to removal of the copper IUD is increased menstrual bleeding. In this review, IUDs with a higher copper dose had a slightly increased risk of discontinuation due to bleeding and other side effects during the first year, but rates of discontinuation were similar among all IUDs over longer follow-up periods.
The possible association between IUD use and pelvic inflammatory disease (PID) is another concern. However, according to data from World Health Organization trials, the primary risk of PID occurs within the first three weeks after IUD insertion and is low thereafter.
The risk of PID is also related to exposure to sexually transmitted diseases. IUD users who are at low risk of sexually transmitted diseases have little long-term risk of PID, even in the first month after insertion.
“If a woman is not at risk of a sexually transmitted infection, then her risk of developing PID that’s attributable to the IUD is practically nil,” Hubacher said.
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