In women who use a copper IUD as a contraceptive, the copper concentration in the fallopian tubes is elevated, but copper and cerulo-plasmin levels in the serum are not changed (Wollen 1994). A number of reports suggest thaL pregnancy in association with copper IUDs results in an increased rate of spontaneous abortions and preterm birth in the group in which the IUD remained in the uterus, compared with the group in which the IUD was removed or expelled. No increase in the rate of birth defects was documented. This is also to be expected with levonorgestrel-containing "intrauterine systems".
Recommendation. From the embtyotoxicity point of view, an IUD remaining in utero is no indication for termination of pregnancy or invasive diagnostic procedures. However, increased spontaneous abortion has been reported with retained lUDs.
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