Abstract: Objective: To observe the clinical effectiveness of Gynefix intrauterine device（IUD） and TCu220C IUD in those women with scarred uterus. Methods：In this randomized control study, 434 women with scarred uterus, who had a history of cesarean section, in our institution from Jan 2012 to Nov 2013 were treated with Gynefix IUD （２２４ ｃａｓｅｓ） ａｎｄ ＴＣｕ２２０Ｃ ＩＵＤ （２１０ ｃａｓｅｓ）． Ｔｈｅ ｃｏｎｔｒａｃｅｐｔｉｖｅ ｅｆｆｅｃｔ ａｎｄ ｓｉｄｅ ｅｆｆｅｃｔ ｉｎ ｔｗｏ ｇｒｏｕｐｓ ｗｅｒｅ ｃｏｍｐａｒｅｄ． Ｒｅｓｕｌｔｓ： Ｔｈｅｒｅ ｗｅｒｅ ４ ｗｏｍｅｎ（０．９２％） ｗｈｏ ｌｏｓｔ ｔｈｅ ｆｏｌｌｏｗ－ｕｐ ｖｉｓｉｔ． Ｔｈｅｒｅ ｗｅｒｅ ｎｏ ｕｔｅｒｉｎｅ ｐｅｒｆｏｒａｔｉｏｎ， ｐｅｌｖｉｃ ｉｎｆｅｃｔｉｏｎ ａｎｄ ｔｈｅ ＩＵＤ ｅｃｔｏｐｉａ ｏｕｔｓｉｄｅ ｕｔｅｒｉｎｅ． Ｔｈｅｒｅ ｗｅｒｅ ｓｉｇｎｉｆｉｃａｎｔ ｄｉｆｆｅｒｅｎｃｅｓ ｉｎ ｔｈｅ ｒａｔｅ ｏｆ ｅｘｐｕｌｓｉｏｎ ａｎｄ ｍｏｖｉｎｇ ｄｏｗｎ （０．９０％ ｖｓ. ３．３７％） ａｎｄ ｔｈｅ ｒａｔｅ ｏｆ ｐｒｅｇｎａｎｃｙ ｗｉｔｈ ＩＵＤ （０．９０％ ｖｓ. ３．８５％） ｂｅｔｗｅｅｎ ｔｈｅ Ｇｙｎｅｆｉｘ ＩＵＤ ｇｒｏｕｐ ａｎｄ ｔｈｅ ＴＣｕ２２０Ｃ ＩＵＤ ｇｒｏｕｐ（Ｐ＜０．０５）． Ｈｏｗｅｖｅｒ， ｔｈｅｒｅ ｗａｓ ｎｏｔ ｓｉｇｎｉｆｉｃａｎｔ ｄｉｆｆｅｒｅｎｃｅ ｉｎ ｔｈｅ ｒａｔｅ ｏｆ ｒｅｍｏｖｉｎｇ ＩＵＤ ｂｅｔｗｅｅｎ ｔｗｏ ｇｒｏｕｐｓ （３．６０％ ｖｓ. ２．８８％， Ｐ＞０．０５）． Ｔｈｅ ｍａｉｎ ｓｉｄｅ ｅｆｆｅｃｔｓ ｉｎ ｔｈｅ Ｇｙｎｅｆｉｘ ＩＵＤ ｇｒｏｕｐ ｗｅｒｅ ｄｙｓｍｅｎｏｒｒｈｅａ ａｎｄ ｍｅｎｏｓｔａｘｉｓ， ｗｈｉｌｅ ｔｈｒｅｅ ｍａｉｎ ｓｉｄｅ ｅｆｆｅｃｔｓ ｉｎ ｔｈｅ ＴＣｕ２２０Ｃ ＩＵＤ ｇｒｏｕｐ ｗｅｒｅ ｍｅｎｏｒｒｈａｇｉａ， ｍｅｎｏｓｔａｘｉｓ ａｎｄ ａｂｎｏｒｍａｌ ｂｌｅｅｄｉｎｇ． Ｔｈｅ ｒａｔｅ ｏｆ ｄｉｓｃｏｎｔｉｎｕａｔｉｏｎ ｉｎ ｔｈｅ Ｇｙｎｅｆｉｘ ＩＵＤ ｇｒｏｕｐ ｗａｓ ｓｉｇｎｉｆｉｃａｎｔｌｙ ｌｏｗｅｒ ｔｈａｎ ｔｈａｔ ｉｎ ｔｈｅ ＴＣｕ２２０Ｃ ＩＵＤ ｇｒｏｕｐ（Ｐ＜０．０５）． Ｍｅanwhile, the rates of menorrhagia and bleeding spotting in the Gynefix IUD group during 3 and 12 month follow-up visiting were significantly lower than those in the TCu220C IUD group （P＜0.05）. Conclusions：Gynefix IUD, with lower rates of expulsion and moving down, pregnancy with IUD, and less side effects compared with TCu220C IUD, is more suitable for those women with scarred uterus who had the history of cesarean section.

Key words: Intrauterine devices, Cicatrix, Uterus, Treatment outcome