To compare the clinical performance of the TCu380A, the most widely us
ed copper IUD in the world today, and a new frameless device, the Cu-F
ix, we report results from a randomized international two-year clinica
l trial involving 874 parous women followed for an average of fourteen
months. Event rates at the end of two years (per 100 women) for pregn
ancy were 0.0 for the TCu380A and 1.5 for the Cu-Fix. Termination due
to expulsion was significantly less for TCu380A as compared with Cu-Fi
x users (2.0 and 11.4 per hundred women, respectively); other medical
reasons for termination (bleeding/pain, pelvic inflammatory disease (P
ID), and other) did not differ significantly. PID incidence rates at t
wo years were 1.0 per hundred women for the TCu380A and 1.6 for the Cu
-Fix (equivalent to 6.0 and 8.3 per 1,000 woman-years, respectively).
The net cumulative continuation rates at two years per hundred women w
ere 78.8 for TCu380A, and 71.9 for the Cu-Fix. Both IUDs provide highl
y effective protection against pregnancy, but the TCu380A has a lower
expulsion rate. The low rate of PID indicates that it is an in-frequen
t occurrence in appropriately selected candidates.