Synstematic Review Of The Performance And Side Effect Of Framelessiud (GyneFix) With Conventional Copper T Shaped IUD

Objective: To evaluate the effectiveness and side effect of Frameless IUD(GyneFix).Methods: We searched The Cochrane Central Register of Controlled Trials,PubMed,EMbase,POPLINE,CBMdisc,CNKI,VIP,WANFANG DATABASE and searched some Relevant medical journal and relevant studies from references. We collected the randomized controlled trails(RCTs) on the comparison between framless IUD and traditional T shaped IUD. The risks of bias of included trials were critically assessed according to the Cochrane Handbook. RevMan 5.0.22software was used for statistical Meta-analyses.Results: Sixteen published studies with total with 9,831participants were included. The results of meta-analysis were expressed with OR [cumulative pregnancy rate,cumulative expulsion rate,cumulative termination rate for bleeding and/or pain,cumulative continuation rate,cumulative intermenstrual change rate, cumulative backache or abdominal pain rate] and 95% CI. GyneFix compared with TCu380A:cumulative expulsion rate lower than TCu380A[at 3years of follow-up showed significant differences 0.55(0.32 , 0.92) ];cumulative termination rate for bleeding and/or pain lower than TCu380A[at 1,2,3years of follow-up showed significant differences 0.63(0.49,0.82);0.65(0.50,0.85);0.80(0.64,0.99)]; cumulative continuation rate higher than TCu380A; cumulative intermenstrual change rate and cumulative backache or abdominal pain rate lower than TCu380A. GyneFix compared with TCu220C:cumulative pregnancy rate lower than TCu220C[at 1,2yesrs of follow-up showed significant differences 0.25(0.11,0.57);0.15(0.04,0.56)];cumulative expulsion rate lower than TCu220C[at 1,2years of follow-up showed significant differences 0.35(0.22,0.56);0.31(0.27,0.56)];cumulative termination rate for bleeding and/or pain lower than TCu220C[at 6 months, 1,2years of follow-up showed significant differences 0.21(0.07,0.68); 0.13(0.06,0.28); 0.14(0.05,0.37)];cumulative continuation rate higher than TCu220C;cumulative intermenstrual change rate and cumulative backache or abdominal pain rate lower than TCu220C.Conclusions: GyneFix showed as high contraception effectiveness as TCu380A, but better performance than TCu220C , largely lower than TCu380A and TCu220C at backache or abdominal pain rate;higher than TCu380A and TCu220C at cumulative continuation rate;little lower than TCu380A at expulsion rate and termination rate for bleeding and/or pain but largely lower than TCu220C ;but at intermenstrual change rate both TCu380A and TCu220C didn't showed obviously effectivenesss after insertion a short time. That shows the framelesss IUD(GyneFix) is a hight-performing,safty,good acceptable contraceptive IUD and can be used more widly, especially minimizes the side effect(backache or abdominal pain) with conventional T shaped IUD. But it didn't show advantages at bleeding after insertion and the included studies existed some risk bias, so a large multicenter randomized, comparative, good designated clinical trail with long follow-up period is still needed to confirm the conclusion, especially at enhancing the trail quality.