Aspect of the cytological endometrial smear obtained from a removed IUD and its relationship to the clinical tolerance of the device

The authors examined the cytological endometrial smears obtained from copper IUDs removed from a group of 232 patients multiparas and nulliparas among whom there were sufficiently represented groups of women who either tolerated the device quite well or who complained of pelvic cramping and bleeding. A remarkable correlation exists between the appearance of the endometrial cell population and clinical tolerance with increased amounts of polimorphonucleates in patients with pelvic cramping and of endometrial epithelial cells in those with more or less marked bleeding. On the contrary however all the cell population in users who tolerated the device well were poorly represented and well-balanced among the various components probably an expression of a favorable adaptation to the device. These data are interesting in that they justify the attitude of those who seeing that the continuation of contraception is necessary carry out the immediate substitution of the device as soon as the suggested period of use has passed without any interval after removal. (authors) (summary in ENG)