CLINICAL-PERFORMANCE OF THE COPPER T200B IUD AFTER REINSERTION FOLLOWING LIFE-SPAN EXPIRATION

The purpose of this study was to evaluate the first year clinical perf ormance of the TCu200B IUD in a cohort of women who had the IUD re-ins erted immediately after a removal for life-span expiration, compared w ith a group of initial accepters, and a cohort of women who continued using the device for more than 60 months. The sample consisted of 1066 users, 339 in each of the two first groups and 388 in the third. Life -table analysis was used to calculate continuation and gross discontin uation rates by reason. Statistical significance of the differences be tween groups was tested by log-rank method. Pregnancy rates were low, both in the group of re-insertions and first insertions, and no pregna ncies occurred in the group using the device beyond the fifth year. Th e expulsion rate and lost-to-follow-up (LFU) rate were significantly l ower in the group of women who used the device beyond the fifth year. In addition, this group showed a significantly higher rate of removal for investigator's choice. These results show that there is no reason to recommend the removal and replacement of the TCu200B before the end of the sixth year of use. When a new IUD is to be inserted after remo val for life-span expiration, providers should be instructed to insert it immediately after the removal, because this procedure does not pos e additional risks, reduces the number of clinic visits, and relieves the women of the use of a temporary method while waiting for the re-in sertion.