Tracking of the micro-structural changes of levonorgestrel-releasing intrauterine system by positron annihilation lifetime spectroscopy.

The morphology and the micro-structural changes of levonorgestrel-releasing intrauterine systems (IUSs) were studied in relation to the duration of their application. The morphology of the removed IUSs was examined without pre-treatment by scanning electron microscopy. The micro-structural changes of the different layers of IUSs were tracked by positron annihilation lifetime spectroscopy. Besides the previously found incrustation formation, the free volume of the hormone containing reservoir was remarkably increased after 3 years of application, thus increasing the real volume of the core of the systems. Although the free volume of the membrane encasing the core was not significantly changed in the course of the application, as a result of the core expansion, microcracks could be formed on the membrane surface. Along these cracks, deposits of different compositions can be formed, causing inflammatory complications and influencing the drug release of IUSs. Stability tests in combination with micro-structural screening of such IUSs could be required during their development phase to avoid the undesired side effects.