Table 3.
Summary of findings
| Study | IUD types (N*) | Age at insertion (years) | Study period | Continuation rates % (n) |
Discontinuation rates % (n) |
Removal for bleeding/pain % (n) | Expulsion % (n) | Pregnancy % (n) |
| Studies of IUD types currently available in the UK only involving nulliparous women aged ≤30 | ||||||||
| RCT | ||||||||
| Otero-Flores et al 44*† | TCu 380A (375) TCu 380A Nul (367) ML Cu 375 sl (374) |
23.2±6.8 22.4±6.6 22.6±6.4 |
12 months | 30.7 (115) 91.3 (335) 89.0 (333) |
69.3 (260) 8.7 (32) 11.0 (41) |
61.6 (231) 3.81 (14) 6.68 (25) |
3.47 (13) 1.91 (7) 1.87 (7) |
1.07 (4) 0.54 (2) 0.00 (0) |
| Non-RCT | ||||||||
| Abraham et al19 | Cu T380A (201) Cu T380A (44) Cu T380A (201) Cu T380A (44) |
20–25 <20 20–25 <20 |
12 months 24 months |
82 [95% CI 76-87] 79 [95% CI 64-89] 73 [95% CI 66-79] 64 [95% CI 48-77] |
ns ns |
ns ns |
ns ns |
ns ns |
| Hall and Kutler34 | Cu T 380A (21) | 18–30 | 12 months | 73.7 (14) | 26.3 (5) | 10.5 (2) | 10.5 (2) | 5.26 (1) |
| Studies of IUD types currently available in the UK involving nulliparous women of all ages | ||||||||
| RCTs | ||||||||
| Sivin and Stern46ठ| TCu 380A (2254) TCu 220C (1301) TCu 200 (4215) |
<20–35+ <20–35+ <20–35+ |
2 years | 55.7 57.8 54.2 |
44.3 42.2 45.8 |
21.9 19.5 16.8 |
7.8 9.8 9.8 |
0.8 1.6 5.1 |
| Non-RCTs | ||||||||
| Akintomide et al30 | TT380 Slimline (27) Mini TT380 Slimline (53) |
15–37 16–37 |
1 year | 66.7 (18) 86.8 (46) |
33.3 (9) 13.2 (7) |
ns ns |
3.7 (1) 3.77 (2) |
0 (0) 0 (0) |
| Elkhateeb et al32 | TCu 380A (90) | 16–>30 | 6 months | 94.4 (85) | 5.6 (5) | ns | 0 (0) | ns |
| Kaislasuo et al35† | Nova T380 (42) | 18–43 | 1 year | 83.3 (35) | 16.7 (7) | ns | 4.76 (2) | ns |
| Roy et al45 | TCu 380A (785) TCu 300 (347) TCu 200 (472) |
<14–>33 15–>33 <14–>33 |
12 months | 81.9 80.7 74.2 |
18.1 19.3 25.8 |
9.1 9.2 10.7 |
3.8 6.1 5.4 |
0.2 0.6 1.7 |
| Studies of IUD types comparable to those available in the UK involving nulliparous women of all ages | ||||||||
| RCTs | ||||||||
| Luukkainen et al39§¶ | Nova T200 (ns) Cu T200 (ns) |
≤19–≥35 ≤19–≥35 |
12 months | ns ns |
ns ns |
15.3 23.4 |
6 10.8 |
0.53 2.3 |
| Allonen et al31§¶ | Nova T200 (ns) Cu T200 (ns) |
≤19 -≥35 ≤19 -≥35 |
24 months | ns ns |
ns ns |
23.5 24 |
6.5 14 |
1.14 5.28 |
| Nygren et al42§ | Nova T200 (ns) Cu T200 (ns) |
<20 ->35 | 36 months | 36.9 31.0 |
ns ns | 28.3 (74) 28.2 (68) |
10.3 (27) 10.7 (26) |
1.5 (4) 6.5 (15) |
| Larsen et al36§ | Cu T200 (99) | 15–44 | 12 months | 73 | 27** | 16 | 5 | 1 |
| Luukkainen et al40 | Nova T200 (77) | 17–40 | 12 months | 73.1 | 26.9** | 10.4 | 9.2 | 0 |
| Ostergard and Gunning43 | TCu 200 (117) TCu 200 (115) |
18–34 | 6 months 12 months |
88.9 (104) 73.0 (84) |
11.1 (13) 27.0 (31) |
6.0 (7) 12.2 (14) |
3.41 (4) 6.09 (7) |
0 (0) 0 (0) |
| Non-RCTs | ||||||||
| Fugere33 | Nova T200 (54) | 17–42 | 24 months | ns | ns | 17.2 | 1.9 | 0 |
| Lewit37 | TCu-200 (2099) Nulligravid subgroup: TCu-200 (1585)† Age subgroups: TCu-200 (1130) TCu-200 (2468) TCu-200 (1513) TCu-200 (683) TCu-200 (449) |
15–49 15–49 15–19 20–24 25–29 30–34 35–49 |
1 year 1 year 1 year 1 year 1 year 1 year 1 year |
73.3 75.9 67.3 73.8 77.6 81.7 85.2 |
26.7 24.1 32.7 26.2 22.4 18.3 14.8 |
9.4 9.6 7 8.3 5.8 7.9 6.8 |
10.7 8.7 15 8.5 8.7 6 3.1 |
1.3 0.8 2.3 2.8 1.5 0.4 0.3 |
| Liedholm and Sjöberg38 | T-Cu 200 (208) | 14–40 | 12 months 24 months |
70.2 60.3 |
29.8 39.7 |
18.1 28 |
0.5 0.5 |
2.9 (6) 2.9 (6) |
| Mishell et al41§ | TCu 200 (471) | 14–33 | 3 months 6 months 12 months |
92.6 84.5 74.2 |
7.4 15.5 25.8 |
2.8 5.8 10.7 |
2.6 4.7 5.4 |
0.2 0.4 1.7 |
| Timonen et al47 | T Cu-300 (138) | <25–40+ | 12 months | 84.7 | 15.3 | 7.2 | 1.6 | 1.6 |
*Sample size or participants excluding those lost to follow-up or removals to plan pregnancy.
†Nulligravid women only.
‡A combination of double blind studies.
§Net cumulative rates.
¶Data obtained from graphs or figures.
**Not stated; obtained by subtraction of continuation rate from 100.
IUD, intrauterine device; ns, not stated; RCT, randomised controlled trial.