Levonorgestrol containing IUCD prevents pregnancy primarily due to: March 2007
Ans. A: Making endometrium unreceptive There are 2 categories of intrauterine contraceptive devices: Ine and copper -based devices, and Hormonally-based devices that work by releasing a progestogen. Most non-hormonal IUDs have a plastic T-shaped frame that is wound around with pure electrolytic copper wire and/or has copper collars (sleeves). All copper-containing IUDs have a number as pa of their name. This is the surface area of copper (in square millimeters) the IUD provides. Hormonal intra-uterine devices Hormonal uterine devices do not increase bleeding as ine and copper-containing IUDs do. They alter the cervical mucus, makes it thick which prevents penetration of sperm and causes atrophy of the endometrium .Rather, they reduce menstrual bleeding or prevent menstruation altogether, and can be used as a treatment for menorrhagia. Contraindications of IUCD Postpaum between 48 hours and 4 weeks (increased IUD expulsion rate with delayed postpaum inseion) Suspected pregnancy Distoions of the uterine cavity by fibroids or anatomical abnormalities Current PID IUDs may safely be inseed at any time during the menstrual cycle as long as it is reasonably ceain the woman is not pregnant. Inseion may be more comfoable if done midcycle, when the cervix is naturally dilated. Side Effects and Complications The inseion process carries a small, transient increased risk of PID in the first 20 days following inseion. After IUD inseion, Menstrual periods are often heavier, more painful, or both - especially for the first few months after they are inseed. On average, menstrual blood loss increases by 20-50% after inseion of a copper-T IUD. Increased menstrual discomfo is the most common reason for IUCD removal. Complications include expulsion and uterine perforation. The risk of ectopic pregnancy: pregnancies that do occur during IUD use a higher than expected percentage (3-4%) is ectopic.
Making endometrium unreceptive
Suppressing ovulation
Initiating inflammatory changes within the endometrium
Making cervical mucus thin