RESUMO
This study included 51 non-pregnat women in the age of 20-40 years. They were divided into three groups: Cases of the first group were 31 IUD [Cu T 380] wearers with bleeding; those of the second group were 10 IUD [Cu T 380] wearers with no complaint and the third group comprised 10 healthy non-pregnant non-IUD wearers and with no past history of using any contraceptive method. Measurement of serum copper was done for all cases by a colorimetric method. The serum copper level in IUD wearers with bleeding [301.27 +/- 152.2 mug/ 100 ml] and IUD wearers without bleeding [346.8 +/- 96.7 mug/ 100 ml] were significantly higher than non-IUD wears [75.2 +/- 59.3 mug/100 ml]. The difference between IUD wearers with bleeding and IUD wearers without bleeding was statistically insignificant. Hysteroscopy and endometrial curettage were done for the 41 IUD wearers. Displacements of IUD were found in sixteen cases of the thirty-one IUD wearers with bleeding, thirteen cases had downward displacement and three cases had lateral displacement; while in IUD wearers without bleeding, only one case had minimal asymptomatic downward displacement. Endometritis was found in seven cases of IUD wearers with bleeding, three cases of them showed abnormal ectatic vascular channels. It was concluded that hysteroscopy was indicated for IUD wearers with bleeding to evaluate the IUD fitting in the uterine cavity and to detect any displacement in addition to the proper screening of the cervical canal and uterine cavity for visible pathology and/or anomaly. Endometrial curettage, preferably after removal of the device, should be done in cases with persistent and excessive IUD induced bleeding for accurate pathological diagnosis