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Contraception - Management
Which copper intrauterine devices (IUDs) are preferred?

  • The preferred copper intrauterine devices contain 380 mm2 of copper, have banded copper on the arms, and are licensed for longer duration of use.
Clarification / Additional information
  • Copper intrauterine devices (IUDs) licensed for up to 10 years of use are available.
  • The IUDs available in the UK, their licensed durations of use, and other characteristics are listed in Availability.
Basis for recommendation
  • These recommendations are based on guidance issued by the National Institute for Health and Clinical Excellence (NICE) [National Collaborating Centre for Women's and Children's Health, 2005].
  • The recommendation to use framed copper intrauterine devices (IUDs) with 380 mm2 copper is based on results from randomized controlled trials:
    • Women using the Multiload Cu375 had a higher cumulative pregnancy rate (5.3%) compared with women using TCu 380A (3.4%) for up to 10 years.
    • Women using Nova-T 380 had a cumulative pregnancy rate of under 2% for up to 5 years.
    • There was no significant difference in cumulative pregnancy rates between the frameless devices (0% to 2%) and the framed device (TCu 380A, 0.3% to 1.6%) after 3 years of use.
  • The recommendation from NICE to prefer IUDs with 380 mm2 copper supersedes that issued in an earlier guideline published by the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC), which recommended at least 300 mm2 copper [FFPRHC, 2004a].
  • The advice to use a copper IUD with the longest licensed duration of use is intended to minimize the risks associated with re-insertion of replacements [FFPRHC, 2004a; National Collaborating Centre for Women's and Children's Health, 2005].

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