IUD Uterine Vascularization and Side Effects

This study has been completed.
Sponsor:
Collaborators:
UFRGS
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Information provided by:
Hospital de Clinicas de Porto Alegre
ClinicalTrials.gov Identifier:
NCT00489463
First received: June 19, 2007
Last updated: June 20, 2007
Last verified: January 2006
  Purpose

The aim of this study was to evaluate the effect of the LNG-IUS and TCU 380A users on the sub-endometrial vascularization and the uterine artery blood flow using power Doppler analysis and ultrasonography pulsed color Doppler during the precise mid-luteal phase.


Condition Intervention
Healthy
Device: intra-uterine device (TCu 380A)

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind
Primary Purpose: Diagnostic
Official Title: The Effect of the Levonorgestrel-Releasing Intrauterine System and the Copper-Intrauterine Device (TCu 380A) on Subendometrial Microvascularization and Uterine Artery Blood Flow.

Further study details as provided by Hospital de Clinicas de Porto Alegre:

Primary Outcome Measures:
  • Ultra-sound doppler, IP and IR indexes [ Time Frame: 3 mo ]

Secondary Outcome Measures:
  • pelvic pain, uterine bleediing [ Time Frame: 3 mo ]

Enrollment: 63
Study Start Date: January 2004
Study Completion Date: November 2006
  Hide Detailed Description

Detailed Description:

Design We will perform a prospective (quasi-experimental) clinical trial. Patients/Methodology We prospectively will enrolled consecutive patients who wants to use IUD (LNG-IUS or TCU 380A). We will evaluate the sub-endometrial blood flow using power Doppler analysis, uterine artery blood flow using pulsatility and resistance index and endometrial thickness before IUD insertion and three months later.

The inclusion criteria are: 1. regularly menstruating women (menstrual cycle varying between 24-35 days); 2. Normal serum TSH, FSH and prolactin levels (as measured on day-3) and with less than 40 years. Contraceptive pills or any kind of hormonal medication had not been taken for (at least) 3 months prior to the study and any intrauterine device had necessarily been removed at least 3 months earlier. Patients will be allowed to not use non-steroidal anti-inflammatory drugs (NSAID) within 24 h prior to any examination.

The exclusion criteria are pregnancy, acute or chronic pelvic inflammatory disease, menorrhagia for unknown reason, copper allergy, cervicitis, dysplasia in the cervix or genital tumor. All patients underwent a gynecological examination and had a Papanicolaou smear taken during the previous 12 months.

All patients will be daily examined with US after the eighth day of the cycle, and follicular development will be observed to confirm ovulation; they are then examined in the mid-luteal phase, 6-9 days after ovulation, to obtain the power Doppler energy (PDE) measurement, pulsatility index (PI), resistance index (RI) and endometrial thickness (ET) by ultrasound (US) scans. The study was approved by the Ethical Committee of Hospital de Clinicas de Porto Alegre, IRB equivalent (# 02-127) and informed consent was obtained from all patients.

Patients will be allocated into 2 groups according to the IUD: LNG-IUS (group A) or TCu 380A (group B).

Three months after the LNG-IUS (group A) or TCu 380A (group B) insertion, also in the mid-luteal phase (6-9 days after ovulation, confirmed by US), all subjects repeated the same study protocol.

The sonographic equipment that will be used consisted of a SONOACE 9900 (Medison SA – Korea). The PDE, PI and RI will be performed on a transvaginal route. The settings for Power Doppler sonography are standardized for the highest sensitivity in the absence of apparent noise using a high pass filter at 50 Hz, pulsed repetition frequency at 750 Hz, and moderate long persistence. The lowest possible measurable velocity was below 5 cm/s. The same investigator, using the same equipment and parameters will performe the sonography assessments so as to eliminate any interobserver variation. All exams were carried out between 08:00 and 10:00 a.m. in order to avoid interference of the circadian rhythm (10).

Power Doppler energy is classified into 5 categories according to the sub-endometrial signal area percentage: I (<10%), II (10-25%), III (25-50%), IV (50-75%) and V (>75%).

Statistics Student t test is used for comparing age and body mass index (BMI). The Wilcoxon-Mann-Whitney (WMW) test is used to compare skewed data (PI, RI and ET), whereas the Chi-Square test and Fisher’s exact test are used for categorical data (PDE).

We will use multiple logistic regression model to examine the association of the outcome (PI variability, before and after IUD insertion), categorized in percentile 50 and IUD (LNG-IUS or TCu 380A), age (years), and parity (0,1 or >1) the independent variables. P-value < 0.05 was considered statistically significant. The power calculation before this study protocol required the inclusion of 19 patients for a Pß=80%.

  Eligibility

Ages Eligible for Study:   18 Years to 40 Years
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Regularly menstruating women (menstrual cycle varying between 24-35 days);
  • Normal serum TSH, FSH and prolactin levels (as measured on day-3) and with less than 40 years. Contraceptive pills or any kind of hormonal medication had not been taken for (at least) 3 months prior to the study and any intrauterine device had necessarily been removed at least 3 months earlier. Patients were allowed to not use non-steroidal anti-inflammatory drugs (NSAID) within 24 h prior to any examination.

Exclusion Criteria:

  • Pregnancy, acute or chronic pelvic inflammatory disease, menorrhagia for unknown reason, copper allergy, cervicitis, dysplasia in the cervix or genital tumor. All patients underwent a gynecological examination and had a Papanicolaou smear taken during the previous 12 months.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00489463

Locations
Brazil
Hospital de Clinicas de Porto Alegre
Porto Alegre, RGS, Brazil, 90003051
Sponsors and Collaborators
Hospital de Clinicas de Porto Alegre
UFRGS
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Investigators
Principal Investigator: Joao Cunha-Filho, PhD Professor UFRGS
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00489463     History of Changes
Other Study ID Numbers: IUD vascularization
Study First Received: June 19, 2007
Last Updated: June 20, 2007
Health Authority: Brazil: National Committee of Ethics in Research

Keywords provided by Hospital de Clinicas de Porto Alegre:
LNG-IUS
TCu 380A
Ultrasonography
Doppler color
power Doppler
female
Volunteers

ClinicalTrials.gov processed this record on April 23, 2014