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    782175

    Ectopic pregnancy rates in IUD users [letter]

    AZNAR R; BERRY CL; COOKE ID; CUADROS A; GRAY R; MCNICOL GP; NEWTON JR; PIZARRO E; ROWE PJ; SHAW ST Jr

    British Medical Journal. 1978 Mar 25; 1(6115):785-6.

    The steering committee of the Task Force on Intrauterine Devices for Fertility Regulation of the World Health Organization's Special Program of Research, Development, and Research Training in Human Reproduction has cited the following reservations regarding the hypothesized link between IUD use and ectopic pregnancy: 1) while available data suggest a real increase in the risk of ectopic pregnancy for IUD users, the magnitude of this risk cannot be quantitated in the absence of adequate comparative studies with nonusers; 2) the presentation of ectopic pregnancy rates as a percentage of total pregnancies may be affected by the conception-dependent reduction in intrauterine pregnancy rates; thus, ectopic pregnancy rates should be expressed as a life table rate/100 woman-years; 3) the risk factors predisposing to ectopic pregnancy vary between population and users of different methods, introducing bias unless this variability is considered in the study design; 4) failure to state the criteria for the diagnosis of ectopic pregnancy may have led to an overestimation of its incidence. Decidual reaction and/or blood in the Fallopian tubes are not sufficient diagnostic indicators; fetal parts (identified grossly or microscopically) and/or trophoblast must be identified; and 5) the limited data available and lack of comparability between studies do not permit the conclusion that Progestasert IUD users are at a higher risk of ectopic pregnancy, as has been suggested in recent reviews.
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