intra uterine device (the right contraceptive choice)
TRANSCRIPT
Intra Uterine Device (THE RIGHT CONTRACEPTIVE CHOICE)
2
A BRIEF HISTORY OF CONTRACEPTIVES
For centuries men and women have been searching for the ultimate contraceptive method starting from the most parochial to the most modern
From potions to rituals Different barrier methods Modern methods as condoms Injectables and implants Contraceptive pills To the most efficient …..IUD’s
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MECHANISMS OF ACTION OF COPPER IUDS
IUD prevents fertilization by:
Impairing the viability of the sperm Interfering with sperm movement Interferes with ovum transport and
fertilization. Stimulates a sterile body reaction in the
endometrium.
COURTESY…IPPF PUBLICATIONS
4
ADVANTAGES OF COPPER IUDS
The Copper-T IUD is the most effective reversible method of birth control
It is effective for at least 10 years. The rate of Ectopic pregnancy is very low,
only 2 in 10,000 women. Fertility is restored immediately on
discontinuation of method.
Source… FHI International ( Family Health International)
5
ADVANTAGES CONT’D The Copper T is very cost-effective over time. It is convenient & safe method of
contraception. The Copper T IUD can be used by women
who cannot use estrogen containing birth control pills.
It may be used by lactating women.
6
WHY IUDS Copper T 380A…the proven way to safe
contraceptiveThree broad advantages for the IUD usage
Advantage for the country program…
Advantage for the provider…
Advantage for the end user…
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ADVANTAGE FOR THE COUNTRY PROGRAM
Cost effectiveness Decrease in the fertility rate Increase in the controlled population Acceptability…religious & other
considerations Decrease in abortion rates Environmentally friendly Decrease in maternal mortality
8
COST EFFECTIVNESS
The cost of the IUD is least compared to the other methods
Source…Contraceptive Technology Update Series…Family Health International
ANNUAL CONTRACEPTIVE COSTS FOR VARIOUS METHODS
$25
$18
$6
$42
$13
$31
$9
$32
$1$2$2$3
$0
$5
$10
$15
$20
$25
$30
$35
$40
$45
BOLIVIA INDIA THAILAND NIGERIA
ANNU
AL C
OSTS
IN U
S$
OCP
CONDOM
IUD
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DECREASE IN FERTILITY RATE
Increase in the iud’s usage results in the decrease in the fertility rate for example. Egypt
IUD PREVELANCE & FERTILITY RATE IN EGYPT
28
3538
4246
50
56
5.14.8
4.64.2
3.83.5
3.3
0
10
20
30
40
50
60
1980 1985 1988 1992 1995 1998 2000
YEAR
IUD
PR
EV
EL
AN
CE
0
1
2
3
4
5
6
FE
RT
ILIT
Y
RA
TE
IUDPREVELANCE
FERTILITYRATE
Source…Development Statistics Data (World Bank)/UNICEF Publication
10
INCREASE IN CONTROLLED POPULATION
Compared with the oral pills, condoms and injectibles, once the user starts using the IUD, it becomes fairly easier to provide other reproductive health facilities.
IUDORAL PILLS CONDOMS INJECTABLES
Motivation required Not Reqd Reqd Reqd Reqd
Pre-Screening Reqd Reqd Reqd Reqd
Over all check up's On visit Not Reqd Not Reqd Not Reqd
Reliability High Average Low Average
Counselling Given Not Reqd Not Reqd Optional
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RELIGION AND IUD PREVELANCE
35
2522
20
45
35
25
15
0
5
10
15
20
25
30
35
40
45
50
MUSLIMS CATHOLICS PROTESTANTS OTHERS
MAJO R RELIGIO NS
Pe
ren
tag
e
URBAN
RURAL
ACCEPTABILITY ..RELIGIOUS & OTHER CONSIDERATIONS
The use of IUD is accepted by all major religions in the world
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ENVIRONMENTAL EFFECT
A news clippings
from The Straits Times, Singapore shows the adverse affect of oral contraceptive pills on environment
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ENVIRONMENTALLY FRIENDLY The packaging waste generated by IUD’s is negligible
compared to the waste packets of condoms, the oral pills & injectables.
Assumption….If all people of the reproductive age. sample size 1.5 Billion were to use a single method
0.48 6 18
234
050
100
150200250
Waste Packets (in billions)
Pieces
IUD
'S
INJE
CT
AB
LE
S
PIL
LS
CO
ND
OM
SCO NTRACEPTIVE TYPES
ENVIRO NMENTAL WASTE (Packets Generated (in billion)PIECES)
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0.9
1.0 1.2
1.4
2.0
1.9
0
10
20
30
40
50
60
Mortalityrate per
100,000 women
15
-19
20
-24
25
-29
30
-34
35
-39
40
-44
AGE
MATERNAL MORTALITY RATE & CONTRACEPTIVE METHODS
NONE
ORAL PILLS
IUDS
BARRIER METHODS
DECREASE IN MATERNAL MORTALITY
IUD usage reduces the pregnancy related deaths
Reference…World Health Organization/Report of WHO Scientific Group)
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ADVANTAGE FOR THE PROVIDER
Compared to other methods the IUDs require lesser follow ups
METHOD FOLLOW UP CYCLE
A. ORAL PILLS ONCE IN 6 MONTHS
B. CONDOMS WHENEVER REQD
C. DMPA ONCE IN 3 MONTH
D. CIC’S ONCE A MONTH
E. IUD’S ONCE A YEAR
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ADVANTAGE FOR THE END USER
Life span of the contraceptive. Efficacy. Decline in ectopic pregnancy Continuation rate Advantage to the end user.
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ADVANTAGE TO THE END USER
LIFE SPAN OF IUD & OTHER METHODS
TCu 380A has a sustained life span of 10 years
as compared to the other methods
METHODS LIFE SPAN
TCu 380 A 10 YEARS
ORAL PILLS 1 MONTH
INJECTABLES 3 MONTHS
CONDOMS. ONE USE
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Rate of Pregnancy With Typical Use
Cop
per
T
(380
A)
0%
5%
10%
15%
20%
25%
30%
Cop
per
T
(380
A)
Min
i Pill
Com
bine
d P
ill
Mal
e C
ondo
m
Dia
phra
m
Fem
ale
Con
dom
Sper
mic
ide
Methods
Percentage
EFFICACY Failure percentage of different methods with
typical use
Source…Contraceptive Technology Update Series…Family Health International
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LOW ECTOPIC PREGNANCIESUse of TCu 380 A has one of the lowest rates of ectopic
pregnancies.ESTIMATED ECTO PIC PREGNANCY RATES BY METHO D
0.020.40.6
1.5
2.3
6.5
IUD
TC
u3
80
A,
0.2
0
1
2
3
4
5
6
7
NO
ME
TH
OD
DIA
PH
RA
GM
CO
ND
OM
FE
MA
LE
STE
RIL
IZA
TIO
N
OC
P
IUD
TC
u38
0A
MA
LE
STE
RIL
IZA
TIO
N
RA
TE
PE
R 1
00
0 W
OM
EN
YE
AR
S
Source…Contraceptive Technology Update Series…Family Health International
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CONTINUATION RATE
IUD has one of the highest continuation rates
Continuation Rate of different contraceptives
80%
72% 70%67%
63%58%
43%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
IUD
Com
bina
tion
pill Dep
o-P
rove
ra
Per
iodi
cab
stin
ence
Mal
e co
ndom
Dia
phra
gm
Sper
mic
ides
Contraceptive methods
Perc
enta
ge
IUD
Combination pill
Depo-Provera
Periodic abstinence
Male condom
Diaphragm
Spermicides
Source…California Journal of Health-System Pharmacy
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ADVANTAGE TO THE END USER
Advisable to women who need effective contraception cover for several years, but who do not prefer to be sterilized.
Advantageous where the accessibility to the regular supply of contraceptives is limited.
The method is cost effective & costs less for the user than any other method.
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ADVANTAGES CONTD
Advantageous to women who are forgetful about using daily contraceptives
Alternative to women taking regular medication that interacts with hormonal contraceptives
Women whose domestic arrangements lack privacy for storing or using other methods of contraceptives.
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THANK YOU