Intra Uterine Device (THE RIGHT CONTRACEPTIVE CHOICE)

2

A BRIEF HISTORY OF CONTRACEPTIVES

For centuries men and women have been searching for the ultimate contraceptive method starting from the most parochial to the most modern

From potions to rituals Different barrier methods Modern methods as condoms Injectables and implants Contraceptive pills To the most efficient …..IUD’s

3

MECHANISMS OF ACTION OF COPPER IUDS

IUD prevents fertilization by:

Impairing the viability of the sperm Interfering with sperm movement Interferes with ovum transport and

fertilization. Stimulates a sterile body reaction in the

endometrium.

COURTESY…IPPF PUBLICATIONS

4

ADVANTAGES OF COPPER IUDS

The Copper-T IUD is the most effective reversible method of birth control

It is effective for at least 10 years. The rate of Ectopic pregnancy is very low,

only 2 in 10,000 women. Fertility is restored immediately on

discontinuation of method.

Source… FHI International ( Family Health International)

5

ADVANTAGES CONT’D The Copper T is very cost-effective over time. It is convenient & safe method of

contraception. The Copper T IUD can be used by women

who cannot use estrogen containing birth control pills.

It may be used by lactating women.

6

WHY IUDS Copper T 380A…the proven way to safe

contraceptiveThree broad advantages for the IUD usage

Advantage for the country program…

Advantage for the provider…

Advantage for the end user…

7

ADVANTAGE FOR THE COUNTRY PROGRAM

Cost effectiveness Decrease in the fertility rate Increase in the controlled population Acceptability…religious & other

considerations Decrease in abortion rates Environmentally friendly Decrease in maternal mortality

8

COST EFFECTIVNESS

The cost of the IUD is least compared to the other methods

Source…Contraceptive Technology Update Series…Family Health International

ANNUAL CONTRACEPTIVE COSTS FOR VARIOUS METHODS

$25

$18

$6

$42

$13

$31

$9

$32

$1$2$2$3

$0

$5

$10

$15

$20

$25

$30

$35

$40

$45

BOLIVIA INDIA THAILAND NIGERIA

ANNU

AL C

OSTS

IN U

S$

OCP

CONDOM

IUD

9

DECREASE IN FERTILITY RATE

Increase in the iud’s usage results in the decrease in the fertility rate for example. Egypt

IUD PREVELANCE & FERTILITY RATE IN EGYPT

28

3538

4246

50

56

5.14.8

4.64.2

3.83.5

3.3

0

10

20

30

40

50

60

1980 1985 1988 1992 1995 1998 2000

YEAR

IUD

PR

EV

EL

AN

CE

0

1

2

3

4

5

6

FE

RT

ILIT

Y

RA

TE

IUDPREVELANCE

FERTILITYRATE

Source…Development Statistics Data (World Bank)/UNICEF Publication

10

INCREASE IN CONTROLLED POPULATION

Compared with the oral pills, condoms and injectibles, once the user starts using the IUD, it becomes fairly easier to provide other reproductive health facilities.

IUDORAL PILLS CONDOMS INJECTABLES

Motivation required Not Reqd Reqd Reqd Reqd

Pre-Screening Reqd Reqd Reqd Reqd

Over all check up's On visit Not Reqd Not Reqd Not Reqd

Reliability High Average Low Average

Counselling Given Not Reqd Not Reqd Optional

11

RELIGION AND IUD PREVELANCE

35

2522

20

45

35

25

15

0

5

10

15

20

25

30

35

40

45

50

MUSLIMS CATHOLICS PROTESTANTS OTHERS

MAJO R RELIGIO NS

Pe

ren

tag

e

URBAN

RURAL

ACCEPTABILITY ..RELIGIOUS & OTHER CONSIDERATIONS

The use of IUD is accepted by all major religions in the world

12

ENVIRONMENTAL EFFECT

A news clippings

from The Straits Times, Singapore shows the adverse affect of oral contraceptive pills on environment

13

ENVIRONMENTALLY FRIENDLY The packaging waste generated by IUD’s is negligible

compared to the waste packets of condoms, the oral pills & injectables.

Assumption….If all people of the reproductive age. sample size 1.5 Billion were to use a single method

0.48 6 18

234

050

100

150200250

Waste Packets (in billions)

Pieces

IUD

'S

INJE

CT

AB

LE

S

PIL

LS

CO

ND

OM

SCO NTRACEPTIVE TYPES

ENVIRO NMENTAL WASTE (Packets Generated (in billion)PIECES)

14

0.9

1.0 1.2

1.4

2.0

1.9

0

10

20

30

40

50

60

Mortalityrate per

100,000 women

15

-19

20

-24

25

-29

30

-34

35

-39

40

-44

AGE

MATERNAL MORTALITY RATE & CONTRACEPTIVE METHODS

NONE

ORAL PILLS

IUDS

BARRIER METHODS

DECREASE IN MATERNAL MORTALITY

IUD usage reduces the pregnancy related deaths

Reference…World Health Organization/Report of WHO Scientific Group)

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ADVANTAGE FOR THE PROVIDER

Compared to other methods the IUDs require lesser follow ups

METHOD FOLLOW UP CYCLE

A. ORAL PILLS ONCE IN 6 MONTHS

B. CONDOMS WHENEVER REQD

C. DMPA ONCE IN 3 MONTH

D. CIC’S ONCE A MONTH

E. IUD’S ONCE A YEAR

16

ADVANTAGE FOR THE END USER

Life span of the contraceptive. Efficacy. Decline in ectopic pregnancy Continuation rate Advantage to the end user.

17

ADVANTAGE TO THE END USER

LIFE SPAN OF IUD & OTHER METHODS

TCu 380A has a sustained life span of 10 years

as compared to the other methods

METHODS LIFE SPAN

TCu 380 A 10 YEARS

ORAL PILLS 1 MONTH

INJECTABLES 3 MONTHS

CONDOMS. ONE USE

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Rate of Pregnancy With Typical Use

Cop

per

T

(380

A)

0%

5%

10%

15%

20%

25%

30%

Cop

per

T

(380

A)

Min

i Pill

Com

bine

d P

ill

Mal

e C

ondo

m

Dia

phra

m

Fem

ale

Con

dom

Sper

mic

ide

Methods

Percentage

EFFICACY Failure percentage of different methods with

typical use

Source…Contraceptive Technology Update Series…Family Health International

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LOW ECTOPIC PREGNANCIESUse of TCu 380 A has one of the lowest rates of ectopic

pregnancies.ESTIMATED ECTO PIC PREGNANCY RATES BY METHO D

0.020.40.6

1.5

2.3

6.5

IUD

TC

u3

80

A,

0.2

0

1

2

3

4

5

6

7

NO

ME

TH

OD

DIA

PH

RA

GM

CO

ND

OM

FE

MA

LE

STE

RIL

IZA

TIO

N

OC

P

IUD

TC

u38

0A

MA

LE

STE

RIL

IZA

TIO

N

RA

TE

PE

R 1

00

0 W

OM

EN

YE

AR

S

Source…Contraceptive Technology Update Series…Family Health International

20

CONTINUATION RATE

IUD has one of the highest continuation rates

Continuation Rate of different contraceptives

80%

72% 70%67%

63%58%

43%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

IUD

Com

bina

tion

pill Dep

o-P

rove

ra

Per

iodi

cab

stin

ence

  

Mal

e co

ndom

Dia

phra

gm

Sper

mic

ides

Contraceptive methods

Perc

enta

ge

IUD

Combination pill

Depo-Provera

Periodic abstinence  

Male condom

Diaphragm

Spermicides

Source…California Journal of Health-System Pharmacy

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ADVANTAGE TO THE END USER

Advisable to women who need effective contraception cover for several years, but who do not prefer to be sterilized.

Advantageous where the accessibility to the regular supply of contraceptives is limited.

The method is cost effective & costs less for the user than any other method.

22

ADVANTAGES CONTD

Advantageous to women who are forgetful about using daily contraceptives

Alternative to women taking regular medication that interacts with hormonal contraceptives

Women whose domestic arrangements lack privacy for storing or using other methods of contraceptives.

23

THANK YOU