History of the IUD and T-shaped Design
The history of the Intrauterine Device (IUD) for birth control is long and tumultuous. Centuries ago, traders In the Middle East prevented pregnancy In camels by inserting pebbles Into their uteri before making long treks across the desert.
The first documentation of this idea for humans was in 1909 with insertions of a ring made of silkworm gut into the uterus.
For several years, different doctors all over the world wrote about their success using variations of intrauterine devices, many of them in the shape of a coil.
Fast forward to 1969 when U.S. physician Howard Tatum tried to decrease the size of the ‘coil’ with the design of a simple plastic T, which was well tolerated but had a pregnancy rate of 18%. That same year it was discovered that copper was an effective spermicide, and the first copper intrauterine device (IUD) was developed. The contraceptive effect of intrauterine copper revolutionized IUD effectiveness. The following year a T shaped device was devised with progesterone (hormone) in a semi permeable capsule in the lower section of the T frame.
The invention of the copper IUD in the 1960s with the capital T shaped design was finally launched in the US in 1988 when the Copper T 380A (ParaGard) was approved by the FDA.
This was followed by a levonorgestrel-releasing (progesterone) intrauterine system (Mirena) made available in the U.S. in 2001. Three more IUDs have since been approved by the FDA and all are still based on the same T-shape design.
Now, more than thirty five years later, the T-shape IUD design, although effective,
presents challenges and problems for both practitioners and patients. This includes difficult and painful insertion that has led to a ‘fear factor’, as well as perforation, expulsion, and the nuisance of dangling strings needed for removal.