Comparison of surface morphology and composition of intrauterine devices in relation to patient complaints

The morphology and the related composition of T-type intrauterine devices (IUDs) made of gold-plated copper were studied in relation to patient complaints. The removed IUDs were examined without pretreatment by scanning electron microscopy and energy dispersive x-ray spectroscopy. Besides the previously found incrustation formation, lamination cracks were observed on the surface of gold-plated copper IUDs causing various side effects (abdominal pain, inflammatory complication). A possible explanation for lamination cracks could be the difference in the heat expansion of the copper and its gold-plated surface and the great difference between the strong acidic galvanizing pH during production and the in utero pH. Stability tests in combination with morphology screening of such IUDs could be required during their development phase to avoid such side effects.