Levonorgestrel Intrauterine System Effects versus Copper Intrauterine Device on Changing Of Menstruation and Uterine Artery Doppler

Abstract

Background: The most effective methods for birth control are the long-acting reversible contraceptives LARCs include Paragard IUD in silver, Mirena IUD in hormonal (progesterone) and hormonal contraceptive implant. The intrauterine levonorgestrel-releasing system (LNG-IUS) and the intrauterine copper unit (Cu-IUD) influenced changing of menstruation and uterine artery Doppler indices Aim of the work: Comparison of the effects of copper intrauterine device (Cu-IUD) and an intrauterine levonorgestrel releasing system (LNG-IUS) on changing of menstruation and Doppler indices of uterine arteries. Methods: This was RCT was completed between February 2017 to January 2020 at the Obstetrics and Gynecology department, Tanta University hospitals. There were two group first group A :LNG-IUS (N=200) and second group B CuIUD (N=200), they were randomly assigned to 400 multiparous women preferring intrauterine contraception., the UA pulsatility index (PI) and the resistant index (RI) were determined at the beginning, and the associations with irregular bleeding were evaluated three and six months after insertion. Results: In group A: LNG-IUS, some women registered irregular bleeding (28 percent) than in the Cu-IUD group (52 percent) at the beginning of the study (P<0.001). There was bleeding irregularity (73 percent) in the group (A): LNG-IUS and severe menstrual bleeding (68 percent) in the Cu-IUD group. The uterine artery PI was associated with bleeding irregularity at value of 1.40, with a curve area (AUC) of 0.91, 90 percent sensitivity, and 100 percent specificity. Uterine artery RI was associated with 0.65 with 0.22 AUC bleeding irregularity, 95 percent sensitivity and accuracy 100 percent. Conclusion: LNG - IUS related irregular bleeding was linked to changes in the blood flow of uterine arteries that were not evident among Cu - IUD users.