Pioneers of the intrauterine device.
This historical review documents the evolution of intrauterine contraception from the introduction of the intrauterine ring by Grafenberg in 1928 to the invention of the frameless device by Wildemeersch in 1984. Enthusiasm about the IUD peaked in the 1960s and 1970s, then declined in the 1980s in response to the dangerous side effects of the Dalkon Shield and high discontinuation rates related to bleeding problems. Other problems included the device's inability to protect against sexually transmitted diseases and the potential for microbiologic invasion from the lower genital tract during insertion. The fact that one of the withdrawn copper IUDs has been reintroduced in the US suggests that a resurgence of support for this method of contraception may be occurring. Bilateral monogamy remains the first prerequisite for use of this contraceptive method.