RESUMO
PIP: In Zhejiang Province, China, there are 2.7 million IUD users. 90% of them use stainless steel single ring. In order to evaluate the effectiveness of the IUDs, the Provincial Family Planning Commission organized a prospective comparative study on 3 kinds of IUDs: the single ring made in Wuxi, the metal ring with plastic core made in Beijing, and the copper TCU 220c made in Tianjin. Between October 1985 and March 1986 1199 healthy women aged 20-39 who had 2 or fewer normal deliveries and without previous history of ectopic pregnancy were screened and recruited to the study. They were randomly assigned to be inserted with the IUDs. 400 women had single ring, 402 women had metal with plastic core, and 397 had TCu 220c. 8 postinsertion follow-up visits were conducted up to 3 years, and menstruations were recorded every month. During the study, 4 cases were lost to follow-up. In the single-ring group, the cumulative continuation rates at 12, 24, and 36 months were 73.4, 66.7, and 65.7% respectively. For the metal-plastic ring group, it was 80.9, 72.3, and 69.3% and for the TCu 220c group, it was 94.5, 88.4, and 83.1%, respectively. The expulsion rates among the 3 kinds of IUDs were statistically significant at 12, 24, and 36 months. The highest expulsion rates were the single ring and TCu 220c were the lowest. The pregnancy rates were highest among metal-plastic ring users and lowest among TCu 220c users. The differences were not statistically significant between single ring and metal-plastic ring users. Discontinuation due to excessive menstrual bleeding were similar among the 3 methods probably due to treatment of the users who experienced excessive bleeding. Younger women and women who experienced fewer pregnancies were found to have higher expulsion and pregnancy rates. But the occurrence of side effects such as prolonged menstrual periods, spotting, and back pain were highest among TCu 220c users. It was recommended that the more effective TCu 220c should be promoted to replace the single ring. Since different sizes of TCu IUDs have been developed, it would be possible to reduce excessive menstrual bleeding and its side effects.^ieng