Reactive oxygen intermediates and reactive nitrogen intermediates in copper intrauterine device users.

ABSTRACT

PIP: There is evidence of an increase in the number of polymorphonuclear leukocytes in the endometrium after insertion of a copper IUD. When activated, these macrophages secrete two groups of toxic metabolites that interact with each other: reactive oxygen intermediates (ROI) and reactive nitrogen intermediates (RNI). The mechanism of action of the copper in copper IUDs as an antimicrobial agent is not well understood. The present study measured ROI and RNI levels in 20 copper IUD users from Chandigarh, India, before and 1, 4, and 12 weeks after insertion. A statistically significant decrease in RNI levels was observed at each postinsertion time. In contrast, ROI levels showed an initial fall at 1 week postinsertion followed by a rise at 4 and 12 weeks. Control of infection has been found to be associated with this pattern of a rise in ROI and fall in RNI. (The initial fall in ROI at 1 week observed in the present study is assumed to be an anomaly related to the introduction of microbials during IUD insertion.) The copper in a copper IUD could be responsible for limiting pelvic inflammatory infection.