From May 1993 to April 1995, 30 general practitioners located at 13 general practice settings in the city of Trondheim, central Norway, recruited 957 eligible participants in a prospective use-effectiveness study on performance of two copper IUDs. In this report we focus on screening for C. trachomatis at insertion and its possible effect on cause-related terminations during the first 90 days after insertion. All women were screened at IUD insertion for C. trachomatis. All specimens were analyzed applying a nucleic acid test (rRNA, GenProbe). Five out of 957 women (0.5%) were positive for C. trachomatis. All were treated within two weeks of diagnosis. No cases of pelvic inflammatory disease were diagnosed during the first three months of the study. Screening of C. trachomatis at IUD insertion is not recommended in Norwegian women because of the extremely low prevalence of C. trachomatis in those who choose IUD as their primary contraceptive method. Recommendations for universally screening women for sexually transmitted diseases at IUD insertion should be based upon review of local/national prevalence data.
PIP: During May 1993 to April 1995, in Norway, 30 general practitioners at 13 different centers in Trondheim recruited 957 parous women, 18-45 years old, in a prospective use-effectiveness study of 2 copper releasing IUDs. They screened for Chlamydia trachomatis infection at insertion. Researchers aimed to examine the effect of C. trachomatis infection on cause-related terminations during the first 3 months of use. Five (0.5%) women tested positive for C. trachomatis infection. All 5 women received antibiotic treatment within 9-15 days after IUD insertion. One woman with chlamydia infection experienced partial IUD expulsion at 9 days. The remaining women continued IUD use without complications. 57 (6/100 women-months) women requested removal of the IUD during the first 90 days of use. No woman requested removal for pelvic inflammatory disease or bleeding and pain. Based on these findings, the authors do not recommend screening for C. trachomatis at IUD insertion in Norwegian women because the prevalence of chlamydia infection was very low in IUD users. They suggest that any recommendations for universal screening of new IUD users for sexually transmitted diseases (STDs) be based upon a review of local/national STD prevalence data.