The purpose of this study was to analyze the reasons for early discontinuation of the TCu-380A IUD in women participating in a large multicenter trial. The study relates specific characteristics of the women at the time of TCu-380A insertion with specific 1-year reasons for discontinuation. A secondary analysis was performed on data obtained from 2748 women from sites in Africa, Asia, and Latin America. By the end of the year, 321 discontinuations were observed. The gross cumulative 12-month life table rates of reasons for discontinuation were 13.3 for all reasons and 3.1, 4.5, and 4.3 for expulsion, removals for bleeding/pain, and personal reasons, respectively. Study site, age, and religion had a significant effect on early discontinuation. Women who had IUD insertions in the African centers had significantly higher expulsion rates than women from other centers. Women < 20 years old had significantly higher expulsion rates than older women. Muslim women had significantly higher rates of removal for bleeding and pain than women of other religions. This information may guide the counseling and follow-up process of women with such characteristics and result in a more satisfactory use and improved continuation rates of the TCu 380A.
PIP: This article presents a secondary analysis of the relationship between client characteristics and reasons for TCu-380A IUD discontinuation. The information gathered in this study served as a guide in the counseling process to ensure better user satisfaction and continuation rates. Data from the international multicenter trial among 2748 women from Africa, Asia, and Latin America were used to assess the continuation/discontinuation status 1 year after device insertion. The 12-month life table rates of reasons for discontinuation were used in the assessment of data. Participants were 18-40 years old, sexually active, with application of the contraceptive device 42 or more days after the last pregnancy. After a year, the rate of discontinuation was 13.3% for all reasons, 4.5% for bleeding/pain, 4.3% for personal reasons, and 3.1% for expulsion. Specific characteristics related to age, parity, religion and study site had significant effects on the discontinuation of IUD use. Women under age 20 were reported to have had a higher expulsion rate than older women, particularly those living in Africa. Removal due to bleeding and pain was found significantly higher among Muslim women compared to women from other religions.