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Intrauterine Devices

Frank Alvarez-Sanchez, MD
JAMA. 1990;263(2):236. doi:10.1001/jama.1990.03440020069026.
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To the Editor.—  In the Questions and Answers section of JAMA1 there is a report on the views of the Diagnostic and Therapeutic Technology Assessment Panelists on intrauterine devices (IUDs).When describing the mechanism of action of the copper-containing IUD, the following statement is made: "The contraceptive action of copper appears to be entirely within the uterus; ovulation is normal but implantation is inhibited."We recently published a study2 that contradicts this theory.Our study consisted of searching for eggs from the tubal and uterine flushings of 115 control subjects who were not using contraceptives and 56 IUD users (of which 27 were Copper T 200 users). All were undergoing surgical sterilization within 132 hours following the luteinizing hormone peak.The percent of ova recovered from the tubal flushings of the IUD group was lower (39%) compared with the percent recovered in the control group (56%) (.05<


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