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Geneva, World Health Organization, 1966. (Technical Report Series NO. 332).The value and possible hazards of IUDs are discussed. Grafenberg developed a metal ring IUD in 1928. There was initial enthusiasm about the device, but it became discredited and interest was not revived in the method until 1959. Today, various shapes, sizes, and materials are employed in making IUD'S. No single cause or mechanism of action of an IUD has so far come to light. In sub-human primates the IUD causes accelerated passage of ova through the tube and the rest of the reproductive tract appears to be the major, but not necessarily the only, mechanism, of action. In ruminants, the contraceptive action of the IUD is exerted, at least in part, at the ovarian level. In rats, mice, rabbits, and ferrets, the main effect of the IUD is suppression of the implantation. It is concluded that the action of the IUDs in the human species is exerted before the stage of implantation. The most effective devices are associated with an incidence of 1.8 to 2.9 pregnancies per 100 insertions during the first year of use. The frequency of spontaneous expulsion ranges from about 5% to over 20% depending on the type of device. About one half of all expulsions occur in the first 3 months and comparatively few after the first year. The incidence of removal for medical reasons ranges from approximately 10% to 25% of first insertions during the first year. The method can be used successfully by almost 3 out of every 4 women who adopt it. Side effect and complications include bleeding and pain and less frequently pelvic inflammatory disease and perforation. The only absolute contraindications to the use of IUDs are: (1) active pelvic inflammatory disease, and (2) pregnancy, proven or suspected. Research needs are noted.
Geneva, Switzerland, WHO, 1993 Nov 16. 2 p. (Press Release WHO/90)In a World Health Organization (WHO) Global Program on AIDS (GPA) meeting held November 11-13, 1993, it was decided to launch a research effort to develop a safe antimicrobial agent capable of inactivating HIV in a woman's vagina. The ideal microbicide will be in the form of a foam or gel to be applied in the vagina; will prevent HIV from attaching itself to the lining of the vagina; will protect against other sexually transmitted diseases; and will not impair fertility. While many existing contraceptive spermicides have been shown to confer protection against HIV in the test tube, no evidence exists to show that they protect against HIV in actual sexual intercourse. Some studies have even suggested that their use may damage the vagina and increase the risk of HIV transmission, especially when used frequently and in high doses. Even though condom use and safer sex practices are widely promoted along with steps to control other sexually transmitted diseases, these measures are inadequate against the transmission of HIV. Where the male-female transmission of HIV is concerned, the Executive Director of the WHO/GPA argues that a safe, effective microbicide is needed for women to use especially when they may be at a loss to negotiate partners' condom use. Further information on coordination efforts may be obtained by contacting the WHO GPA Public Information Officer in Geneva.