Long term effects of IUD on the human endometrium. Histologic, histochemical and ultrastructural studies.

To evaluate the longterm effects of a IUD on the human endometrium and find the possible contraceptive mechanism of the IUD, histologic, histochemical, and ultrastructural studies of human endometrial biopsies from 44 normal contorls and 178 IUD wearers were made. Histologic findings included interstitial hemorrhage, inflammatory reaction, hyperplasia, atrohy, focal necrosis, and squamous metaplasia. However, all of these findings were either infrequent or insignificant except for inflammatory reaction. Histochemical, enzymatic, and ultrastructural findings were also unremarkable. The most significant finding was asynchronism between cyclic dating and endometrial histologic dating, showing delayed endometrial maturation in the majority of IUD users. In summary, IUD insertion results in mild histologic-alteration in the human endometrium but the inflammatory reaction and asynchronous endometrial maturation may play some role in the antifertility action of an IUD. author's modified