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Review article| Volume 73, ISSUE 2, P145-153, February 2006

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Does insertion and use of an intrauterine device increase the risk of pelvic inflammatory disease among women with sexually transmitted infection? A systematic review

  • Anshu P. Mohllajee
    Affiliations
    Division of Reproductive Health, WHO Collaborating Center in Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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  • Kathryn M. Curtis
    Correspondence
    Corresponding reviewer. Tel.: +1 770 488 6397; fax: +1 770 488 6391.
    Affiliations
    Division of Reproductive Health, WHO Collaborating Center in Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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  • Herbert B. Peterson
    Affiliations
    Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA

    Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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      Abstract

      Concerns exist as to whether the insertion of copper and levonorgestrel-releasing intrauterine devices (IUDs) increases the risk of pelvic inflammatory disease (PID) among women with sexually transmitted infection (STI). We searched the MEDLINE database for all articles published between January 1966 and March 2005 that included evidence relevant to IUDs and STIs and PID. None of the studies that examined women with STIs compared the risk of PID between those with insertion or use of an IUD and those who had not received an IUD. We reviewed indirect evidence from six prospective studies that examined women with insertion of a copper IUD and compared risk of PID between those with STIs at the time of insertion with those with no STIs. These studies suggested that women with chlamydial infection or gonorrhea at the time of IUD insertion were at an increased risk of PID relative to women without infection. The absolute risk of PID was low for both groups (0���5% for those with STIs and 0���2% for those without).

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