NL 2014/02

Happy Birthday, Jack Lippes!
The inventor of the Lippes Loop IUD is turning 90





In the 1950s the US gynaecologist Jack Lippes constantly heard many of his patients express their frustration with the limited selection of contraceptive methods available at that time, essentially diaphragms and condoms. The pill hadn’t appeared yet, and doctors tended not to prescribe IUDs as a matter of course, considering them neither effective nor safe enough. Furthermore, these methods were condemned in gynaecological textbooks. When they were prescribed in spite of all that, patients were sworn to absolute secrecy so that the doctor wasn’t ostracised by his or her colleagues.

Lippes thought that “something better” was needed and began experimenting. Proceeding from Gräfenberg’s ring, which was widely used in the 1930s, he rethought the IUD’s underlying principle. Other doctors considered his work “radical”, warning Lippes that he would eventually be sued as a result. But Lippes didn’t let this stop him and completed his experiments, some of them on his own some with money he had managed to scrape together and some with the aid of friends. For example, Helen Bronnenkant sacrificed a baking sheet for moulding the first coils, and her husband, Paul Bronnenkant, a test pilot in WWII and the head of Hallmark Plastics, participated due to his great interest in engineering. In extended series of experiments, Lippes tested various types of plastics, the flexibility of the various models, their sizes in relation to the dimensions of the uterus, the best type of thread for removal, effectiveness and side effects, and he optimised the shape.

 

A new shape increased effectiveness

In 1962 Lippes presented his new design at the first international conference on IUDs: a double S-shaped device made of plastic called the Lippes Loop. Thanks to its trapezoidal shape, it fits the uterine cavity perfectly and has a far lower expulsion rate than earlier designs. The Lippes Loop became the gold standard against which all IUDs were measured. Available in four sizes, it was in the 1970s the most frequently prescribed intrauterine device in the US. Thanks to its flexibility, this design could be straightened and inserted into the uterus in a cannula, which caused no pain. Furthermore, it showed up on x-rays, which facilitated checks.

In 1973, Lippes and collegues published the first results concerning how conception was affected by copper, which was moulded into the smallest model, A. The underlying idea was that IUDs need not be inert foreign bodies that prevent conception merely through their presence in the uterus. Instead, they can also function as vehicles for pharmacological effective substances – like copper. Indeed, the initial trials showed an increase in effectiveness, which was however accompanied by more side effects. After that, Lippes examined the optimum type and amount of copper and he already considered possible uses of his development in ‘morning-after contraception’.

 

Decades of use in family planning

Jack Lippes, born in Buffalo, New York, on 19 February 1924, did his MD and worked at a number of gynaecological clinics. Before becoming a professor emeritus in 1999, Lippes taught gynaecology and obstetrics at his alma mater (State University of New York at Buffalo, School of Medicine) in addition to running a private practice for nearly 35 years. Lippes was the medical director of Planned Parenthood of Buffalo and set up that city’s first in-vitro clinic. He also played an important role in the spread of quinacrine sterilisation for women, a simple and inexpensive non-surgical method used frequently in developing countries.

Lippes performed a number of tasks around the globe, such as in Afghanistan, India, Iran, Pakistan, South Korea, Taiwan and Tunisia. Lippes received a number of awards for his life work and was the first American ever to be given the European Society of Contraception and Reproductive Health’s medal. On 19 February Jack Lippes will turn 90.

 

The Museum of Conception and Abortion has a number of Lippes Loops, prototypes and relevant research reports, and documents this groundbreaking achievement in the history of IUDs.

Visit the Museum for Contraception and Abortion (MUVS), Mariahilfer Gürtel 37, 1150 Vienna, open Wednesday to Sunday, 2 to 6 p.m., or visit our website on http://en.muvs.org/ and our facebooksite http://www.facebook.com/eMUVS.