WO2011080164A1 - Improvements to frameless intrauterine devices and systems - Google Patents
Improvements to frameless intrauterine devices and systems Download PDFInfo
- Publication number
- WO2011080164A1 WO2011080164A1 PCT/EP2010/070434 EP2010070434W WO2011080164A1 WO 2011080164 A1 WO2011080164 A1 WO 2011080164A1 EP 2010070434 W EP2010070434 W EP 2010070434W WO 2011080164 A1 WO2011080164 A1 WO 2011080164A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- iud
- thread
- copper
- hollow
- previous
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F6/00—Contraceptive devices; Pessaries; Applicators therefor
- A61F6/06—Contraceptive devices; Pessaries; Applicators therefor for use by females
- A61F6/14—Contraceptive devices; Pessaries; Applicators therefor for use by females intra-uterine type
- A61F6/142—Wirelike structures, e.g. loops, rings, spirals
Definitions
- the invention relates to a new and improved "frameless" copper-releasing or hormone-releasing intrauterine
- contraceptive device or system (IUD/IUS) .
- GyneFix ® The known frameless copper intrauterine device, called GyneFix ® ' has six copper tubes, each 5 mm long and 2.2 mm wide, threaded on a length of thread or suture material. This was generally disclosed in US 4,708,134 or EP
- the proximal end of the device is provided with an anchoring means for its fixation to the uterine wall in order to prevent that the device is pushed out by the uterus .
- Another known device or system is the frameless hormone- releasing FibroPlant ® which is similar to the GyneFix ® IUD but instead of copper cylinders, as the active component, is provided with a fiber or several fibers or loops held together in one assembly zone, and which releases the hormone in the uterine cavity.
- the hormone such as steroid hormone, is a contraceptive and/or a therapeutic agent.
- An anchoring means similar to the above mentioned one is also provided for its fixation in the uterine wall. This was generally disclosed in US 5,433,218 or EP0445150.
- the preferred means is to suspend the IUD or IUS in the uterine cavity simply by providing a knot in the anchoring thread and then pushing such in the wall of the uterus by means of an applicator comprising, for example, a stylet-tip
- a knot in the context of the present invention consists of a location of the thread were the thread has been deformed and/or multiply folded in such a way to produce a
- the mass of thread may be produced by intertwining and/or its stability enhanced by local fusion of the thread which is made at least partially of
- the dimension of the knot is larger than the diameter of the thread, for example 3 to 6 times larger, typically between 0.8 and 2.0 mm.
- the proximal end of the thread becomes a short appendix extending from the knot.
- the knot or deformation in the thread is small in volume and of a form suitable to allow its withdrawal under the effect of sufficient pulling, form the tissue of the uterus without damaging the latter.
- Both active substances, copper and the hormone-releasing fibrous delivery system, can be visualized and their position in the uterine cavity can be checked by
- the stainless steel tube can be kept extremely small. It is also important that the right material is used as the material should be biocompatible because the tiny steel tube will remain in the uterine wall for months or years until the IUD/IUS is removed .
- Another aspect of the current improvement to frameless copper devices is related to the size of the copper elements loaded onto the IUD.
- the abovementioned device known as GyneFix ® comprises copper cylinders and is very efficient as the inner surface of the copper cylinders is in contact with the uterine environment, thereby increasing the effective copper surface area, as there is no plastic frame. This, as mentioned, is different from other known copper IUDs .
- This standard prior art "frameless” IUD has an effective copper surface area of approximately 330 mm2 and is a highly effective intrauterine contraceptive system. In randomized clinical trials, it has been shown to be more effective that the most effective copper IUD available on the market. In addition, with this IUD, because of its smaller size and flexibility, the effect on menstrual blood loss is reduced when compared with the larger, conventional copper-releasing IUDs.
- IUDs An important drawback of IUDs is indeed their tendency to cause heavy, sometimes painful, menstrual bleeding. Heavy bleeding is the commonest cause for IUD discontinuation. Discontinuation rates for bleeding vary from 7.0 to 12.0 during the first year of use. In the USA, an estimate of 36% of IUD users terminate during the first year for reasons other than the desire for pregnancy, including heavy menstrual bleeding and pain. Heavy menstrual bleeding may have a deleterious effect on health among normally healthy women. This is especially the case in women living in deprived developing countries where increased menstrual blood loss may precipitate or aggravate iron deficiency anaemia. It has been reported that even minute increases in menstrual blood loss may adversely affect the health of women especially during long-term use of IUD contraception.
- Anaemia is common according to a recent report of the WHO (World Health Organization) .
- WHO World Health Organization
- the incidence of anaemia in Western Europe and the USA is about 8%, in the other
- an IUD device is provided with a means to increase the release of copper from the smaller device.
- the active body is made of at least two metals forming a plurality of galvanic cells in the uterine environment and is accomplished by making an alloy or microscopic mixture of the different metals. It has been shown that it is especially desirable to design a device of which the active substance is copper and to add at least one metal which has a higher electropositivity such as gold. The copper elements then form the anode and the gold the cathode of the galvanic cell. The uterine environment functions thereby as the electrolyte .
- the improvement is obtained not by providing an alloy or mixture but surprisingly it is simply accomplished by alternating copper cylinders with small gold cylinders, creating these galvanic cells. In this way, the device remains, as intended, highly flexible resulting in optimal tolerance by the patient.
- the primary aim of the present invention is to provide a means to make the current anchor visible on ultrasound and x-ray to allow the provider to check if the anchor is properly placed in the wall of the uterus since the performance of the frameless IUD/IUS depends on correct placement of the anchor.
- the visualization of the anchor thereby significantly increases the safety of the
- anchoring concept This goal is reached by adding a tubular metal element to the anchor fixed onto the anchoring thread just below the anchoring knot and/or on the appendix of the anchoring knot.
- this method of realization does not hinder the anchor for suspending the copper IUD or of the hormone-releasing IUS when inserted with an applicator into the musculature of the uterine fundus .
- the anchoring knot may also be treated with metal dust attached or incorporated in the material of the anchoring knot or deformation of the thread serving as anchor.
- the anchoring knot is preferably created by heat
- the secondary aim of the present invention is to provide a copper IUD to minimize the impact on menstrual blood loss.
- This device has a smaller total (nominal) surface area but a large effective copper surface area, when compared to the effective copper surface area of the high-load conventional copper IUDs .
- the total surface area of the IUD does not exceed 275 mm2. According to one preferred embodiment it will not exceed 200 mm2.
- the effective copper surface area equals the nominal copper surface area which should be at least 200 mm2.
- the components are copper cylinders and are not longer than 6 to 8 mm in order to allow easier direct contact between theinner surface of the cylinders and the uterine
- all copper cylinders are kept inplace by two small copper clips, one above and one below
- the clips may be cylinders identical to the copper cylindersbut which have been crimped. The design of the device and the manufacturing process may therefore be simplified.
- approximated copper elements of the IUD is not longer than 2.6 cm .
- the total length of the IUD is not longer than 3.0 cm when the copper elements are freely separated .
- the hollow elements are separated from each other by a small space to enhance the contact between the inner part of the cylinders and the uterine environment. According to yet another characteristic of
- the hollow elements are not larger than 3.0 mm in diameter in order to allow easy insertion in the uterinecavity .
- the inner diameter of the hollow elements is at least 1.6 mm in diameter to allow a high total (inner and outer) effective copper surface area similar to high-load copper IUDs.
- the number of elements may be between 2 and 10, preferably between 3 to 6. Particularly preferred is a structure comprising 4 cylindrical elements, each
- a way to increase the copper release to enhance the inactivation by the copper ions on the sperm cells which is the main mechanism of action of copper IUDs.
- copper and gold enter into an electrochemical reaction.
- An alloy of copper and noble metal creates a multitude of local tiny galvanic (alkaline) batteries when in contact with the uterine environment (which serves as an electrolyte) .
- fungicidal effects which are expected to lessen the risk of pelvic inflammatory disease (infection) .
- At least one short 2.0-3.0 mm gold tube is crimped onto the suture thread, f° r example one above and/or one below the four copper tubes .
- An additional purpose of the invention is to reduce the risk of expulsion in cases where the uterine wall is soft (e.g., postpartum) by the provision of biodegradable material added to the anchoring knot. This can be
- biodegrable material is a polylactide or polycaprolactone .
- FIG.l is an enlarged schematic sectional view of the anchor provided with a thin tube which is threaded just below the anchoring knot.
- FIG. 2 represents the anchor as in Fig. 1 provided with a thin tube threaded and affixed onto the appendix of the anchor.
- FIG. 3 is a schematic cross sectional view of the uterus with a preferred embodiment of an IUD according to the invention
- Fig. 3' is a schematic cross sectional view of the uterus with a preferred embodiment of a
- FIG. 4 represents a view of a preferred embodiment of a copper-releasing IUD according to the invention
- FIG. 5 is a transversal sectional view of a copper element of the invention
- FIG. 6 is another view of an embodiment according to the invention of which the copper elements are separated from each other to enhance the contact between the inner surface of the hollow cylinders and the uterine fluid,
- FIG. 7 represents another view of embodiments according to the invention of which the copper elements are separated from each other by gold or silver tubes forming galvanic cells in succession,
- FIG.8 is a sectional schematic view of a mode of realization where a biodegradable cap is added and covers the anchoring knot for enhanced retention in the fundal part of the uterus.
- an anchor is provided by making a knot 5 in a suture thread 3 of which one of the ends is cut, leaving a relatively short appendix 4 extending from the knot.
- a tiny tube 6 of maximum 2 mm long and less than double the size of the suture thread to allow its easy insertion in the wall of the uterus with a specially designed inserter.
- a small loop 12 extending from the knot 5 and designed to cooperate with an inserter for pushing the not into the fundal tissue of the uterus.
- an IUD is made of a material which is physiologically active in the uterine cavity, consisting of 4 hollow longitudinal members 2, open at both ends, and arranged in a sequence in order to form a longitudinal flexible body.
- elements 2 are threaded on a length of thread 3, for example a polypropylene suture material.
- the sleeve members or elements 2 are prevented from sliding off the material by the upper and lower sleeves which are at least partially crimped onto the thread.
- the proximal end of the thread is provided with a fixing means 5 which is pierced by about 1 cm in the fundal part of the uterine cavity 1 to secure the IUD therein and prevent expulsion.
- the resulting device has no rigid plastic body, making it a completely flexible and supple unit.
- the IUD is made of hollow elements of which the total surface area is at least two times smaller when compared to a well-known conventional IUD (TCu380A) as shown in FIG. 5.
- Tu380A well-known conventional IUD
- Fig. 4 shows the same anchoring technology as in Fig. 3, according to the invention, but the copper tubes are replaced by a fibrous delivery system 7 affixed to the anchoring thread by means of a metal cylinder 8 crimped onto the anchoring thread.
- FIG. 6 is a transversal sectional view of an
- FIG. 7 which illustrates a IUD according to one embodiment, which comprises 4 hollow elements, open at both ends, separated from each other by a spacer 9, being provided crimped onto the thread or not, to enhance the contact with the uterine environment 11.
- such crimped elements can be made of a noble metal.
- Figure 8 is one of the preferred embodiments of the invention in order to increase the inactivating impact on sperm cells, bacteria and viruses.
- the cross sectional view shows a copper-releasing IUD according to the
- Figure 9 is a sectional view of a preferred mode of realization of the "enhanced" anchor showing a cross sectional view of the anchoring knot with biodegradable bell-shaped cap 13 pushed over it.
- the present invention discloses, among others, in a non limitative way :
- an intrauterine contraceptive device comprising: a plurality of elongated hollow, metabolically active members, open at both ends and arranged longitudinally onto a thread, one end of which comprises an anchoring means to retain to the fundal part of the uterine cavity , such device forming a non-rigid structure of limited dimensions, characterised in that: the structure has a total surface area not exceeding 275 mm 2 ; the length of the structure, when the hollow members are closely approximated is less than 2.6 cm, and not more than 3.0 cm when the members are freely separated along said thread, and its diameter is not more than 3.30 mm, preferably not more than 3.00 mm; and the hollow members have an inner diameter of at least 1.6 mm but less than 2.5 mm, and/or
- an intrauterine contraceptive device for insertion in the uterus comprising: a plurality of hollow,
- metabolically active elements arranged longitudinally to form a non-rigid structure of limited dimensions;
- the elements are copper cylinders are at least 2.4 mm in diameter and maximum 2.8 mm in length; a structure of which the wall thickness of each or part of the copper cylinders is at least 0.4 mm, with the following additional optional features :
- the hollow members are hollow cylinders or sleeves, the length thereof being equal to or less than 8 mm;
- the wall of the hollow members is partially cut out or perforated
- the hollow members are made of copper
- ⁇ one or some of the hollow members (2) are made of copper and the other (s) of gold and/or silver;
- the hollow members 2 are kept in place by two small crimped clips, one above and one below the hollow
- the clips are also hollow elements, possibly of shorther length, having been crimped or flattened onto the thread;
- the number of members 2 is between 3 to 8, preferably around 4 ;
- the total copper load is minimally 350 mg
- ⁇ retaining thread is made of polypropylene and/or has at least 0-gauge size US;
- the total length of the hollow members does not exceed 2.5 cm
- the effective copper surface area is between 220 mm 2 and 280 mm 2 ;
- the hollow member is made of copper and has a length between 1 and 9 mm and a diameter which is between 0.1 and 0.3 mm larger than the size of the suture thread (3) on which the tiny metal tube is threaded;
- the hollow members are copper cylinders and the wall thickness of each or part of the copper cylinders is at least 0.4 mm.
- a metallic element such as a steel cylinder at the anchoring location inside the tissue of the uterus
- noble metal cylinders such as gold or silver cylinders, threaded adjacent to copper elements
- knot for anchoring the device which is capped by a biodegradable component, such knot being not necessarily completly embedded in the biodegrable component.
Abstract
Description
Claims
Priority Applications (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA2784602A CA2784602A1 (en) | 2009-12-21 | 2010-12-21 | Improvements to frameless intrauterine devices and systems |
BR112012015285A BR112012015285A2 (en) | 2009-12-21 | 2010-12-21 | enhancement of frameless intrauterine system and device |
CN201080058690.6A CN102781377B (en) | 2009-12-21 | 2010-12-21 | Improvements to frameless intrauterine devices and systems |
US13/518,078 US20120318276A1 (en) | 2009-12-21 | 2010-12-21 | Frameless intrauterine devices and systems |
EP10805786.0A EP2515806B1 (en) | 2009-12-21 | 2010-12-21 | Improvements to frameless intrauterine devices and systems |
RU2012130602/14A RU2555389C2 (en) | 2009-12-21 | 2010-12-21 | Improvement in frameless intrauterine devices and systems |
ZA2012/05024A ZA201205024B (en) | 2009-12-21 | 2012-07-05 | Improvements to frameless intrauterine devices and systems |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/EP2009/067709 WO2010112095A1 (en) | 2009-04-03 | 2009-12-21 | Improvement to intrauterine copper contraceptive devices |
EPPCT/EP2009/067709 | 2009-12-21 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2011080164A1 true WO2011080164A1 (en) | 2011-07-07 |
Family
ID=44012350
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP2010/070434 WO2011080164A1 (en) | 2009-12-21 | 2010-12-21 | Improvements to frameless intrauterine devices and systems |
Country Status (5)
Country | Link |
---|---|
CN (1) | CN102781377B (en) |
CA (1) | CA2784602A1 (en) |
RU (1) | RU2555389C2 (en) |
WO (1) | WO2011080164A1 (en) |
ZA (1) | ZA201205024B (en) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2013061341A1 (en) * | 2011-10-28 | 2013-05-02 | Sujoy Kumar Guha | An improved intra-uterine contraceptive device |
EP2708213A1 (en) | 2012-09-13 | 2014-03-19 | PAT&Co bvba | Multipurpose ethylene vinyl acetate fibrous drug delivery systems for long-term implantation or insertion |
US10987244B2 (en) | 2008-09-17 | 2021-04-27 | Bayer Oy | Inserter |
US11432958B2 (en) | 2008-09-17 | 2022-09-06 | Bayer Oy | Inserter |
US11872155B2 (en) | 2008-09-17 | 2024-01-16 | Bayer Oy | Inserter |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2017025502A1 (en) * | 2015-08-07 | 2017-02-16 | Pat&Co Bvba | Novel instrument for the insertion of a bioactive frameless or framed intrauterine device or intrauterine system through a hysteroscope |
Citations (3)
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EP0191747A1 (en) | 1985-02-05 | 1986-08-20 | Dirk Wildemeersch | Contraceptive intra-uterine device and device for insertion and attachment to the uterine cavity wall |
EP0445150A1 (en) | 1988-11-23 | 1991-09-11 | Dirk Wildemeersch | Intra-uterine device. |
EP2308428A1 (en) * | 2009-10-07 | 2011-04-13 | Bio Material Systems | Device and method for reversible office sterilization |
Family Cites Families (7)
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US4949732A (en) * | 1989-08-24 | 1990-08-21 | Gyno Pharma Inc. | Apparatus for insertion and fixation of an intra uterine contraceptive device to the uterine fundus |
RU2070007C1 (en) * | 1992-04-08 | 1996-12-10 | Александр Петрович Линецкий | Intrauterine contraceptive device |
RU2049449C1 (en) * | 1992-06-01 | 1995-12-10 | Акционерное предприятие "Вектор" | Intrauretral contraceptive |
US7073504B2 (en) * | 1996-12-18 | 2006-07-11 | Ams Research Corporation | Contraceptive system and method of use |
FR2769828B1 (en) * | 1997-10-22 | 2000-03-17 | 7 Med 97 Sarl Societe D Etudes | INTRAUTERINE ANTI-CONCEPTIONAL DEVICE COMBINED WITH ITS INSERTION SYSTEM |
BE1012671A3 (en) * | 1999-05-07 | 2001-02-06 | Wildemeersch Dirk | Intra-uterine device increased efficiency and reduced side effects. |
FI123188B (en) * | 2005-04-05 | 2012-12-14 | Bayer Oy | Ultrasonically detectable intrauterine system |
-
2010
- 2010-12-21 CA CA2784602A patent/CA2784602A1/en not_active Abandoned
- 2010-12-21 CN CN201080058690.6A patent/CN102781377B/en active Active
- 2010-12-21 WO PCT/EP2010/070434 patent/WO2011080164A1/en active Application Filing
- 2010-12-21 RU RU2012130602/14A patent/RU2555389C2/en not_active IP Right Cessation
-
2012
- 2012-07-05 ZA ZA2012/05024A patent/ZA201205024B/en unknown
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0191747A1 (en) | 1985-02-05 | 1986-08-20 | Dirk Wildemeersch | Contraceptive intra-uterine device and device for insertion and attachment to the uterine cavity wall |
US4708134A (en) | 1985-02-05 | 1987-11-24 | Wildemeersch Dirk A A | Intrauterine contraceptive device and device for its insertion and fixation to the uterus |
EP0445150A1 (en) | 1988-11-23 | 1991-09-11 | Dirk Wildemeersch | Intra-uterine device. |
US5433218A (en) | 1988-11-23 | 1995-07-18 | Dirk Wildemeersch | Intra-uterine device |
EP2308428A1 (en) * | 2009-10-07 | 2011-04-13 | Bio Material Systems | Device and method for reversible office sterilization |
Cited By (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10987244B2 (en) | 2008-09-17 | 2021-04-27 | Bayer Oy | Inserter |
US11432958B2 (en) | 2008-09-17 | 2022-09-06 | Bayer Oy | Inserter |
US11850182B2 (en) | 2008-09-17 | 2023-12-26 | Bayer Oy | Inserter |
US11872155B2 (en) | 2008-09-17 | 2024-01-16 | Bayer Oy | Inserter |
US11911312B2 (en) | 2008-09-17 | 2024-02-27 | Bayer Oy | Inserter |
WO2013061341A1 (en) * | 2011-10-28 | 2013-05-02 | Sujoy Kumar Guha | An improved intra-uterine contraceptive device |
EP2708213A1 (en) | 2012-09-13 | 2014-03-19 | PAT&Co bvba | Multipurpose ethylene vinyl acetate fibrous drug delivery systems for long-term implantation or insertion |
WO2014041120A1 (en) | 2012-09-13 | 2014-03-20 | Pat&Co Bvba | Multipurpose drug delivery systems for long-term implantation or insertion |
Also Published As
Publication number | Publication date |
---|---|
CN102781377A (en) | 2012-11-14 |
RU2555389C2 (en) | 2015-07-10 |
CN102781377B (en) | 2016-08-10 |
CA2784602A1 (en) | 2011-07-07 |
ZA201205024B (en) | 2013-02-27 |
RU2012130602A (en) | 2014-01-27 |
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