A review of barriers and myths preventing the more widespread use of intrauterine contraception in nulliparous women

Figures & data

Table 1 Intrauterine contraception: the mechanism of action is not abortifacient (adapted from Schulman et al. 2009)60.

	Copper IUD	LNG-IUS
Effects on sperm
Sterile foreign body reaction in uterine cavity results in changes that may be toxic to sperm52^,54^,55^,61	✓	✓
Release of copper ions is spermicidal or cytotoxic52^,54^,61	✓
Thickening of cervical mucus may impede sperm transport through the cervix (preventing sperm reaching the egg)61Effect on fertilisation		✓
Decrease in the number of fertilised ova in Fallopian tubes compared with women not using contraception52^,54^,55^,61Effects on the endometrium	✓	✓
Increases leukocytes in the endometrium61	✓
Altered cytokine and integrin profile in the endometrium61	✓	✓
Endometrial suppression, decreased thickness and secretions61		✓

Schulman L, Hess HM, Arias R, et al. Expert Roundtable. Intrauterine contraception: Patient and clinician considerations. OBG Management 2009;July(Supplement):S1–8.

 Google Scholar

Sivin I. IUDs are contraceptives, not abortifacients: A comment on research and belief. Stud Fam Plann 1989;20:355–9.

 PubMed Web of Science ®Google Scholar

Rivera R. Yacobson I, Grimes D. The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices. Am J Obstet Gynecol 1999;181(5 Pt 1):1263–9.

 PubMed Web of Science ®Google Scholar

World Health Organization. Mechanism of action, safety and efficacy of intrauterine devices. Report of a WHO Scientific Group. World Health Organ Tech Rep Ser 1987;753:1–91.

 PubMedGoogle Scholar

Stanford JB, Mikolajczyk RT. Mechanisms of action of intrauterine devices: Update and estimation of postfertilization effects. Am J Obstet Gynecol 2002;187: 1699–708.

 PubMed Web of Science ®Google Scholar