Clinical Experience with Intrauterine Contraceptive Devices (IUDs) Inserted with and Without Tail

Between 1982 and 1984, two comparative clinical trial for testing new types of IUDs, were initiated at the Family Planning Center (Debrecen, Hungary) in collaboration with the Leiras Research Laboratories (Turku, Finland). 685 Nova T and 500 TCu 200Ag IUDs with and without tail were inserted in a randomized manner in order to study the possible role of the thread of the device in generating pelvic inflammatory disease (PID). Because there were no statistically significant differences between the corresponding rates of the devices, the data regardless of the type of the IUD, were pooled, then separated into two new groups: the study group (IUD without tail) consisted of 581 cases, while the control population (IUD with tail) included 602 insertions. The age and parity distribution was the same in both groups (mean age 29.4, mean parity 1.9). In the study group 300 patients completed the two-year follow-up, and 9675 womanmonths of use were evaluated. The corresponding figures for the control population were 304 and 9935, respectively. The two-year gross cumulative termination rates for the study and the control group were as follows: pregnancy 4.4 and 4.6; expulsion 1.9 and 2.9; bleeding/pain removals 6.3 and 6.0, removal for infection 0.2 and 2.7; removal for other medical reason 2.1 and 1.9; removal for planning pregnancy 4.6 and 6.6; removal for other personal reason 1.6 and 0.6. The pregnancy, expulsion and removal rates, except infection, were almost the same in both groups. There was a statistically significant difference only between the rates of removals for PID (p less than 0.05): during the two-year period of use 12 devices were removed for infection and out of these only 1 was inserted without tail! Although these findings are promising, to draw a final conclusion more cases and a longer follow-up are needed.