Rates of pregnancy among levonorgestrel and copper intrauterine emergency contraception initiators: Implications for backup contraception recommendations

Multiple Adverse Outcomes of Intrauterine Devices in One Patient: A Case Report

Intrauterine devices (IUDs) are commonly used, effective forms of long-acting removable contraceptives that may be inserted by primary care providers. Adverse outcomes with copper IUDs specifically have been extensively documented; however, there is little guidance on whether to offer an IUD to a patient who has already experienced adverse outcomes related to IUDs. In this case report, our patient experienced three complications with three different copper IUDs, including a spontaneous expulsion, a fragmented device, and a retained device in addition to two unintended pregnancies. In our view, a different form of contraception should be offered for a patient that has already experienced multiple adverse outcomes related to IUDs.

Exploring the Role of Levonorgestrel Intrauterine System (LNG-IUS) as a Method of Emergency Contraception (EC)

Copper T 380-A (CuT380A) intrauterine device (IUD) has been an effective method of emergency contraception (EC). Levonorgestrel intrauterine system (LNG-IUS) has not been approved by the Food and Drug Association for EC till now. There are few studies that provide data regarding the efficacy of LNG-IUS as EC. This systematic review tried to explore the efficacy of LNG-IUS in preventing accidental pregnancies up to five days of unprotected intercourse. A systematic review of the published studies on the use of LNG-IUS as EC was done. All randomized trials, prospective cohorts, retrospective cohorts. and case-control study designs pertaining to this topic were included in this review. Abstracts were retrieved and reviewed by two authors independently. Variables pertaining to socio-demographic parameters, EC use-related variables (reason for use, frequency, time elapsed since coitus), and those associated with sexual habits were selected and recorded. A total of six articles were rendered for the review. High school students and those attending college accounted for 36.8%-51.8% of the study population. Data on the reason for seeking EC showed noncompliance to routine contraception as the most common reason, followed by failure of withdrawal method, breach of barrier contraception, and unplanned intercourse. With a negligible failure rate, LNG-IUS seemed to be a good alternative to the existing copper EC. Considering the plethora of noncontraceptive benefits associated, LNG-IUS can be safely provided as an option of EC in the cafeteria approach within five days of unprotected intercourse.