IUDs: Methods of Birth Control

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Intrauterine devices (IUDs) are small T-shaped devices inserted into the uterus to prevent pregnancy, working primarily by creating a hostile environment for sperm and eggs. They come in two main types: copper IUDs, which release copper ions to immobilize sperm, and hormonal IUDs, which release progestin to thicken cervical mucus.
    
Copper IUD Mechanism
Copper IUDs trigger inflammation in the uterine lining, producing substances toxic to sperm and reducing their ability to fertilize an egg. The substances refer to specific biochemical agents released in uterine and genital tract fluids due to IUD-induced inflammation, acting as natural spermicides and embryo-toxins. These include white blood cells (leukocytes), prostaglandins, cytokines, and copper ions (in non-hormonal IUDs), which impair sperm motility, capacitation, and survival. The copper ions enhance this spermicidal effect, making it harder for sperm to survive or move through the reproductive tract.
Hormonal IUD Mechanism
Hormonal IUDs release levonorgestrel, which thickens mucus at the cervix to block sperm entry, thins the uterine lining to prevent implantation, and may suppress ovulation in some users. This multi-layered action primarily inhibits fertilization rather than terminating established pregnancies.
Shared Effects
Both types induce a local immune response in the endometrium, altering fluid composition throughout the genital tract to impair gamete viability and embryo development before implantation. Evidence shows fertilization rates drop significantly in IUD users compared to non-users.

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