Copper IUD's and unwanted infertility: pathophysiology of pelvic inflammatory disease (PID) and sexually transmitted disease (STD).

The Multiload intrauterine device (IUD) and other copper IUDs cause various pathological alterations: thinning of superficial epithelial cells, superficial ulcerations and lesions, disturbances of cyclic development, pseudodecidual stroma, edema of the stroma, broadening of the capillaries, and lesions of the capillaries. The infiltration of numerous polymorphonuclear leukocytes, mononuclear cells, and macrophages in the endometrium and uterine lumen, causes the release of some embryotoxic material. There responses are associated with various pathophysiological alterations such as increased vascularity and membrane permeability of the small capillaries, and the production/release of pro-inflammatory prostaglandins in the endometrium.