This paper introduces the basic content of the compulsory national standard ISO 7439:2015 Copper-bearing contraceptive intrauterine devices--Requirements and tests standard analysis, and expounds the reasons for revising part of the standard during the conversion process according to the actual market situation of intrauterine contraceptive device containing copper in China. As a compulsory basic universal standard, it has a guiding significance for the manufacturers of IUD and can promote the improvement of product quality.
China ; Contraceptive Agents ; Copper ; Female ; Humans ; Intrauterine Devices

OBJECTIVETo investigate the clinical efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of adenomyosis.

METHODSSeventy patients with adenomyosis diagnosed according to clinical symptoms, magnetic resonance imaging (MRI) findings, laparoscopy and/or color-Doppler ultrasound imaging were treated with LNG-IUS, and the menstrual blood volume, dysmenorrhea, uterine volume, hepatic function and serum lipids were observed and evaluated.

RESULTSIn the first month of treatment, the menstrual blood size was reduced significantly to (35-/+12)% of that before treatment (P<0.01), and further to (7-/+4)% in the twelfth month (P<0.01). The average uterine volume was decreased by 18.6% (P<0.05) after the treatment, and dysmenorrhea was obviously relieved or completely disappeared alleviated. The condition of anemia was also improved rapidly, and no obvious side-effects on hepatic function and serum lipids were observed.

CONCLUSIONLNG-IUS is an effective and safe therapy for adenomyosis.

Adult ; Contraceptive Agents, Female ; administration & dosage ; therapeutic use ; Endometriosis ; drug therapy ; pathology ; Female ; Follow-Up Studies ; Humans ; Intrauterine Devices, Medicated ; Levonorgestrel ; administration & dosage ; therapeutic use ; Treatment Outcome

Objective: To evaluate different methods' efficacy of controlling acute bleeding and managing long-term menstruation in patients with heavy menstrual bleeding (HMB) associated with antithrombotic therapy. Methods: The clinical data of 22 cases with HMB associated with antithrombotic therapy admitted to Peking University People's Hospital from January 2010 to August 2022 were analyzed, aged 39 years old (26-46 years). Changes in menstrual volume, hemoglobin (Hb), and quality of life were collected after control of acute bleeding and long-term menstrual management. Menstrual volume was assessed by pictorial blood assessment chart (PBAC), and quality of life was assessed by menorrhagia multi-attribute scale (MMAS). Results: (1) Treatment of acute bleeding: of the 22 cases with HMB associated with antithrombotic therapy, 16 cases were treated in our hospital and 6 in other hospital for emergency bleeding; of the 16 cases treated in our hospital, 3 underwent emergency intrauterine Foley catheter balloon compression due to severe bleeding (Hb decreased by 20 to 40 g/L within 12 hours). Of the 22 cases with antithrombotic therapy-related HMB, 15 (including 2 cases with severe bleeding) underwent emergency aspiration or endometrial resection, and intraoperative placement of levonorgestrel-releasing intrauterine system (LNG-IUS) followed by a significant reduction in bleeding volume; 3 cases had controlled acute bleeding after rivaroxaban dose reduction and continued observation; 2 cases were given gonadotropin-releasing hormone agonists to control acute bleeding in other hospital, of which 1 case was temporarily treated with periodic blood transfusion, and the other one patient underwent total hysterectomy; and 2 cases had temporary amenorrhea with oral mifepristone after intrauterine balloon compression or oral norethindrone. (2) Long-term menstrual management: of the 22 cases with antithrombotic therapy-related HMB, 15 had LNG-IUS placement and 12 had LNG-IUS placement for 6 months, and menstrual volume was significantly reduced [PBAC scores were 365.0 (272.5-460.0) vs 25.0 (12.5-37.5), respectively; Z=4.593, P<0.001], Hb was significantly increased [91.5 g/L (71.8-108.2 g/L) vs 128.5 g/L (121.2-142.5 g/L); Z=4.695, P<0.001], and quality of life was significantly improved [MMAS scores were 415.0 (327.5-472.5) vs 580.0 (570.0-580.0), respectively; Z=-3.062, P=0.002] before placement compared with 6 months after placement. Three rivaroxaban dose reduction patients' PBAC scores decreased by 20 to 35 but remained >100, and perceived quality of life did not change significantly. Two cases with temporary amenorrhea treated with oral mifepristone felt significantly improved quality of life, and the MMAS scores increased by 220 and 180, respectively. Conclusion: Intrauterine Foley catheter balloon compression, aspiration or endometrial ablation could be used to control acute bleeding in patients with antithrombotic therapy-related HMB, and LNG-IUS for long-term management could reduce menstrual volume, increase hemoglobin, and improve the quality of life of patients.
Female ; Humans ; Adult ; Menorrhagia/etiology* ; Fibrinolytic Agents/adverse effects* ; Levonorgestrel/adverse effects* ; Amenorrhea/drug therapy* ; Mifepristone/therapeutic use* ; Quality of Life ; Rivaroxaban/therapeutic use* ; Hemoglobins ; Intrauterine Devices, Medicated/adverse effects* ; Contraceptive Agents, Female

The intrauterine device (IUD) is gaining popularity as a reversible form of contraception. Ultrasonography serves as first-line imaging for the evaluation of IUD position in patients with pelvic pain, abnormal bleeding, or absent retrieval strings. This review highlights the imaging of both properly positioned and malpositioned IUDs. The problems associated with malpositioned IUDs include expulsion, displacement, embedment, and perforation. Management considerations depend on the severity of the malposition and the presence or absence of symptoms. Three-dimensional ultrasonography has proven to be more sensitive in the evaluation of more subtle findings of malposition, particularly side-arm embedment. Familiarity with the ultrasonographic features of properly positioned and malpositioned IUDs is essential.
Contraception ; Contraceptive Devices, Female ; Hemorrhage ; Humans ; Intrauterine Devices* ; Pelvic Pain ; Recognition (Psychology) ; Ultrasonography*

The activity of matrix metalloproteinases (MMPs) in the uterine flushing and endometrial tissue of normal adult women wearing FCu-IUD (fixed Cu-IUD) or FICu-IUD (indomethacin-releasing FCu-IUD) was observed by using zymography on SDS-PAGE containing gelatin. The results showed that the activity and kinds of MMPs in FCu-IUD group were increased significantly as compared with themselves before being inserted FCu-IUD. However, compared with the FCu-IUD group, the activity of some kinds of MMPs in the FICu-IUD group was decreased significantly. These data suggest that IUD can enhance the activity of MMPs in human endometrium, intermediated by prostaglandins, and MMPs may have relation to IUD-induced menorrhagia and indomethacin reduces IUD-induced menorrhagia by partly inhibiting MMPs synthesis.
Adult ; Endometrium ; enzymology ; Female ; Humans ; Indomethacin ; Intrauterine Devices, Copper ; adverse effects ; Intrauterine Devices, Medicated ; adverse effects ; Matrix Metalloproteinases ; metabolism ; Middle Aged ; Uterine Hemorrhage ; etiology ; prevention & control

The activity of matrix metalloproteinases (MMPs) in the uterine flushing and endometrial tissue of normal adult women wearing FCu-IUD (fixed Cu-IUD) or FICu-IUD (indomethacin-releasing FCu-IUD) was observed by using zymography on SDS-PAGE containing gelatin. The results showed that the activity and kinds of MMPs in FCu-IUD group were increased significantly as compared with themselves before being inserted FCu-IUD. However, compared with the FCu-IUD group, the activity of some kinds of MMPs in the FICu-IUD group was decreased significantly. These data suggest that IUD can enhance the activity of MMPs in human endometrium, intermediated by prostaglandins, and MMPs may have relation to IUD-induced menorrhagia and indomethacin reduces IUD-induced menorrhagia by partly inhibiting MMPs synthesis.
Endometrium/*enzymology ; Indomethacin ; Intrauterine Devices, Copper/*adverse effects ; Intrauterine Devices, Medicated/*adverse effects ; Matrix Metalloproteinases/*metabolism ; Uterine Hemorrhage/etiology ; Uterine Hemorrhage/prevention & control

Adult ; China ; Contraceptive Agents, Female ; therapeutic use ; Data Collection ; Female ; Humans ; Intrauterine Devices ; Levonorgestrel ; therapeutic use ; Patient Education as Topic ; statistics & numerical data

An introduction of the design, features and contraceptive principle of an oviduct contraceptive plug is given in this paper. The plug is made of polyethylene, based on the oviductal morphology. It can be introduced and removed by a hysteroscope and is expected to be a transcervical, implantable and permanent intratubal contraceptive device.
Contraceptive Devices, Female ; Equipment Design ; Polyethylene ; Sterilization, Tubal ; instrumentation

BACKGROUND: There is a dearth of studies that explore the perceptions of male partners of adolescent females towards the intention of pursuing contraception.

OBJECTIVE: To determine the role of male partner perceptions in the intention to use of contraception among female adolescents to prevent unplanned repeat pregnancies.

MATERIALS AND METHODS: An urban sample of 102 male partners of female adolescents with previous pregnancy experience coming from the out-patient department and selected barangay health center responded to a two-part questionnaire that explored their perceptions towards contraception. Demographic data and their positive and negative views, attitudes and actual practice of contraception as it affects future intention to engage in family planning methods were determined.

RESULTS: Male sexual partners have positive perceptions towards contraception. Despite this, utilization rate was still low (56.8%). Positively correlated with contraceptive intention include the male partner's advanced age and high level of education. Perceptions that favor strong intention include careful pregnancy planning in the future, not wanting a pregnancy too soon, knowledge of a specific method, its perceived benefits, "shared decision" making, feeling "happy" when contraceptives are offered rather than forced and when a woman lacks trust in him. Forcing contraception by the female adolescent partner was negatively correlated with contraceptive intention.

CONCLUSION: Shared decision making towards contraception in order to reduce unintended pregnancies should engage the male partner's participation by correcting prevailing misperceptions.

Human ; Male ; Female ; Young Adult ; Adolescent ; Pregnancy ; Family Planning Services ; Contraceptive Agents ; Sexual Partners ; Outpatients ; Contraception ; Pregnancy, Unplanned ; Contraceptive Devices

We describe the successful removal of a pelvic contraceptive coil in a symptomatic 46-year-old patient who had Essure devices for four years, using a combined hysteroscopy-laparoscopy-fluoroscopy approach. Following normal hysteroscopy, at laparoscopy the right Essure implant was disrupted and its outer nitinol coil had perforated the fallopian tube. However, the inner rod (containing polyethylene terephthalate) had migrated to an extrapelvic location, near the proximal colon. In contrast, the left implant was situated within the corresponding tube. Intraoperative fluoroscopy was used to confirm complete removal of the device, which was further verified by postoperative computed tomography. The patient's condition improved after surgery and she continues to do well. This is the first report to describe this technique in managing Essure complications remote from time of insertion. Our case highlights the value and limitations of preoperative and intraoperative imaging to map Essure fragment location before surgery.
Colon ; Contraceptive Devices* ; Fallopian Tubes ; Female ; Fluoroscopy* ; Humans ; Hysteroscopy ; Laparoscopy ; Middle Aged ; Polyethylene