Role Of Reactive Oxygen, Nitrogen Intermediates, And Micro-Organisms In The Prevention Of Injuries Related To Copper Intrauterine Devices
Dr Pradip Kumar Saha, Senior lecturer, Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Sector 32, Chandigarh â€“ 160 030.
India. Tel. No.: 91-171-2645262
Objective: The aim was to study reactive oxygen intermediates (ROI) and reactive nitrogen intermediates (RNI) along with the microbiological flora in intrauterine device users before and after its insertion.
Study and design: Fifty three women seeking a copper intrauterine contraceptive device (Cu-IUD), were included in the study. Microbiological flora were studied from endocervical and uterine aspirates along with reactive oxygen and nitrogen intermediates, before insertion of Cu IUD, and subsequently at one, four, and 12 weeks, post insertion. Twenty subjects were also followed up at 24 weeks.
Results: There was a steady increase in reactive oxygen intermediates at 1, 4, and 12 weeks, though it was not statistically significant (p>0.5). On the other hand, there was a decrease in the reactive nitrogen intermediates and L-citrulline levels, which is statistically significant (p<0.5). The number of organisms grown at one week post insertion were more than those present during preinsertion, but there was a steady fall in the number observed at four and 12 weeks. The values of RNI and ROI were the same at 24 weeks follow-up as preinsertion in the 20 subjects.
Conclusion: The balance between reactive oxygen and nitrogen intermediates is perhaps responsible for the action of activated macrophages on different organisms. Presence of microorganisms introduced at the time of insertion of an IUD causes a rise in ROI levels and a fall in RNI levels. Presence of copper in copper IUDs perhaps enhances these reactions.