The postcoital IUD as an effective continuing contraceptive method

doi:10.1016/S0010-7824(86)80011-7

Contraception

Volume 34, Issue 6, December 1986, Pages 549-558

https://doi.org/10.1016/S0010-7824(86)80011-7 Get rights and content

Abstract

A two-year controlled clinical study of the effectiveness of postcoital IUD as a continuing contraceptive method in 98 women requesting a postcoital contraception is presented.

The control group was selected from women requesting an IUD as contraceptive choice.

The rates of accidental pregnancy, expulsion and removal for medical reasons did not differ between the two groups. Removal for personal reasons was the only termination event that showed a significant difference at one year.

Moreover, the removal for personal reasons of interceptive IUD users mainly occurred in the early months after insertion.

Postcoital IUD has proved to be an effective continuing contraceptive method. Special attention and sympathetic counseling should be given to postcoital IUD users before insertion and during the three months following insertion.

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Postcoital hormonal contraception: uses, risks and abuses
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Postcoital oestrogen or IUD?
IPFF Europe Regional Information Bulletin 8 n°
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There are more references available in the full text version of this article.

Cited by (16)

The intrauterine device versus oral hormonal methods as emergency contraceptives: A systematic review of recent comparative studies
2021, Sexual and Reproductive Healthcare
Citation Excerpt :
It is logical to assume that providers are most likely to recommend it when they think the risk of pregnancy is greatest and the effort to insert the IUD and the possible ensuing problems and discomfort are warranted. While the prospect of providing not only emergency contraception but ongoing LARC as well is appealing, this has not proven to be successful in practice in both earlier studies [23,34], and in the studies reviewed in Table 2. None of these newer studies evaluated the risk of pregnancy relative to the day (or in the case of IUDs the days) of unprotected sex.
Oral emergency contraceptives do not appear to be as effective as the copper IUD as an emergency contraceptive. There is as yet no estimation of the relative efficacy rates rather than the failure rates. The references for this study were obtained by entering the terms “intrauterine device” “and “emergency contraception” in Medline, PubMed, Popline, Global Health and ClinicalTrials.gov. Chinese references were obtained from the Wanfang database. For the short term study articles with a defined population who were followed up after the index cycle were eligible. Women who were adequately followed for at least 6 months were included in the long term study.
There were 13(of 228) studies which met our selection criteria and were conducted between August 2011 and January 2019. There were 960 insertions of four types of copper IUD with a failure rate of 0.104%. There were 22 failures out of 1453 oral emergency contraception users with a failure rate of 1.51%. The relative risk of failure for an intrauterine device versus an oral method was 0.1376(95% CI −0.03–0.58). The 6 month to 12 month pregnancy rate was 0–6% for IUDs and 2.7–12% for oral methods.
The copper IUD appears to be more effective than oral methods as an emergency contraceptive. The 6 to 12 month pregnancy rates after using either method is 4–10%. Emergency contraception is not a solution to unintended pregnancy.
Reprint of: Emergency contraception: CNGOF Contraception Guidelines
2019, Revue Sage - Femme
Éditer, par le Collège national des gynécologues et obstétriciens français (CNGOF), des recommandations fondées sur les preuves disponibles dans la littérature pour l’utilisation en termes d’efficacité, de sécurité et d’effets secondaires de la contraception d’urgence (CU).
Une revue de la littérature a été effectuée en consultant les données Medline, Cochrane Library et les recommandations internationales en langue française et anglaise du 1^er janvier 1979 jusqu’au 1^er mai 2018.
Il est recommandé d’informer les patientes que la CU n’est pas efficace à 100 %. Un test de grossesse est recommandé en cas de retard de règles après prise d’une CU. Il est recommandé d’utiliser la CU le plus tôt possible après le rapport à risque. En l’absence de contraception au long cours, dans les 72 premières heures après le rapport sans protection, l’ulipristal acétate (UPA) ou le lévonorgestrel (LNG) peuvent être proposés avec une supériorité de l’UPA entre 0 et 72 h. Au-delà de 72 h, les données suggèrent une meilleure efficacité de l’UPA. Cependant, en prenant en compte des éléments pratiques (accès à la CU, coût, répercussions sur la prise d’une contraception hormonale après UPA), il est difficile de recommander l’UPA en priorité entre 0 et 72 h. Les menstruations sont plus susceptibles d’arriver précocement avec le LNG. Le DIU au cuivre est une méthode efficace et peut être utilisé en CU jusqu’à 120 h après un rapport sexuel non protégé ou en cas de risque d’échec d’une méthode contraceptive.
La contraception d’urgence n’est pas efficace à 100 %. Plus la prise de la CU est proche du rapport à risque, plus elle est efficace en termes de taux de grossesse.
Edit, by the French National College of Gynecologists and Obstetricians (CNGOF), recommendations based on the evidence available in the literature for the use in terms of effectiveness, safety and side effects of emergency contraception (EC).
A review of the literature was conducted by consulting Medline, Cochrane Library and international recommendations in French and English from January 1, 1979 to May 1, 2018.
It is recommended to inform patients that EC is not 100% effective. A pregnancy test is recommended if there is a delay after taking an EC. It is recommended to use EC as soon as possible after the unprotected intercourse. In the absence of long-term contraception, in the first 72 hours after unprotected intercourse, ulipristal acetate (UPA) and levonorgestrel (LNG) may be offered with a superiority of UPA from 0 to 72 h. Beyond 72 hours, the data suggest a better efficiency of the UPA. However, taking into account practical elements (access to EC, cost, impact on the taking of hormonal contraception after UPA), it is difficult to recommend the UPA as a priority between 0 and 72 h. Menstruation is more likely to happen early with LNG. The copper IUD is an effective method that can be used in EC until 120 hours after unprotected intercourse or when there is a risk of contraceptive failure.
EC is not 100% effective. The closer the intake of EC with the unprotected intercourse, the more effective is the EC in terms of pregnancy rate.
Emergency contraception: CNGOF Contraception Guidelines
2018, Gynecologie Obstetrique Fertilite et Senologie
Éditer, par le Collège national des gynécologues et obstétriciens français (CNGOF), des recommandations fondées sur les preuves disponibles dans la littérature pour l’utilisation en termes d’efficacité, de sécurité et d’effets secondaires de la contraception d’urgence (CU).
Une revue de la littérature a été effectuée en consultant les données Medline, Cochrane Library et les recommandations internationales en langue française et anglaise du 1^er janvier 1979 jusqu’au 1^er mai 2018.
Il est recommandé d’informer les patientes que la CU n’est pas efficace à 100 %. Un test de grossesse est recommandé en cas de retard de règles après prise d’une CU. Il est recommandé d’utiliser la CU le plus tôt possible après le rapport à risque. En l’absence de contraception au long cours, dans les 72 premières heures après le rapport sans protection, l’ulipristal acétate (UPA) ou le lévonorgestrel (LNG) peuvent être proposés avec une supériorité de l’UPA entre 0 et 72 h. Au-delà de 72 h, les données suggèrent une meilleure efficacité de l’UPA. Cependant, en prenant en compte des éléments pratiques (accès à la CU, coût, répercussions sur la prise d’une contraception hormonale après UPA), il est difficile de recommander l’UPA en priorité entre 0 et 72 h. Les menstruations sont plus susceptibles d’arriver précocement avec le LNG. Le DIU au cuivre est une méthode efficace et peut être utilisé en CU jusqu’à 120 h après un rapport sexuel non protégé ou en cas de risque d’échec d’une méthode contraceptive.
La contraception d’urgence n’est pas efficace à 100 %. Plus la prise de la CU est proche du rapport à risque, plus elle est efficace en termes de taux de grossesse.
Edit, by the French National College of Gynecologists and Obstetricians (CNGOF), recommendations based on the evidence available in the literature for the use in terms of effectiveness, safety and side effects of emergency contraception (EC).
A review of the literature was conducted by consulting Medline, Cochrane Library and international recommendations in French and English from January 1, 1979 to May 1, 2018.
It is recommended to inform patients that EC is not 100% effective. A pregnancy test is recommended if there is a delay after taking an EC. It is recommended to use EC as soon as possible after the unprotected intercourse. In the absence of long-term contraception, in the first 72 hours after unprotected intercourse, ulipristal acetate (UPA) and levonorgestrel (LNG) may be offered with a superiority of UPA from 0 to 72 h. Beyond 72 hours, the data suggest a better efficiency of the UPA. However, taking into account practical elements (access to EC, cost, impact on the taking of hormonal contraception after UPA), it is difficult to recommend the UPA as a priority between 0 and 72 h. Menstruation is more likely to happen early with LNG. The copper IUD is an effective method that can be used in EC until 120 hours after unprotected intercourse or when there is a risk of contraceptive failure.
EC is not 100% effective. The closer the intake of EC with the unprotected intercourse, the more effective is the EC in terms of pregnancy rate.
Contraceptive efficacy of intrauterine devices
2008, American Journal of Obstetrics and Gynecology
Citation Excerpt :
In 1986, a 2-year controlled clinical study compared the effectiveness of postcoital IUD insertion in 98 Italian women who requested postcoital contraception with a control group that was selected from Italian women who requested an IUD as contraceptive choice. The rates of unplanned pregnancy, expulsion, and removal for medical reasons did not differ between the 2 groups.52 In 1993, a study supported by WHO/Human Reproduction Programme was conducted in 1933 Chinese women (from 20 centers) in which the TCu380A IUD was inserted within 120 hours after unprotected intercourse.
To compare the contraceptive efficacy of various types of intrauterine devices (IUD; copper devices, Nova-T, intrauterine contraceptive systems, levonorgestrel-releasing devices), we reviewed all relevant publications on this subject that have been published over the last 2 decades. The first point to be highlighted by this review is the excellent effectiveness of IUDs, with a global cumulative pregnancy rate <2% at 5 years, whatever the type of device used. We observed a large variation in efficacy rate according to the type of IUD and also according to study design. Nevertheless, of all the types of IUDs, the levonorgestrel-releasing IUD and to a lesser extent the TCu380A IUD seem to be the most effective, with a cumulative pregnancy rate at 5 years of <0.5% for the levonorgestrel-releasing IUD and between 0.3% and 0.6% for the TCu380A IUD.
Effectiveness of emergency contraceptive pills between 72 and 120 hours after unprotected sexual intercourse
2001, American Journal of Obstetrics and Gynecology
Objective: This article reopens the issue of a medical practice that has been well established for more than three decades by proposing an extension of the period during which treatment with the “morning-after” pill is currently prescribed. The objective is to determine the effectiveness of the regimen of Yuzpe and Lancee when it is administered between 72 and 120 hours after sexual intercourse. Study Design: We conducted an observational study comparing 2 groups of women for whom the regimen of Yuzpe and Lancee was administered after unprotected sexual intercourse. One group (usual time frame treatment group) sought consultation within 72 hours (n = 131), and the other (extended time frame treatment group) after 72 to 120 hours (n = 169). Results: The pregnancy rate was 0.8% for the <72-hour group and 1.8% for the 72- to 120-hour group. The effectiveness rate varied from 87% to 90% for the <72-hour group and from 72% to 87% for the 72- to 120-hour group. In both groups the χ² tests showed that emergency contraceptive pills significantly reduced the risk of pregnancy. Conclusions: Women should be encouraged to seek consultation as quickly as possible after unprotected sexual intercourse. However, if the usual time limit (<72 hours) has expired, the so-called “morning-after” pill should be recommended if an intrauterine contraceptive device is not available. Emergency contraceptive pills have a favorable success rate after 72 hours, with a pregnancy rate that is significantly lower than would be expected if no contraceptive were administered. (Am J Obstet Gynecol 2001;184:531-7.)
Endometrial suction in luteal phase as a method of late postcoital contraception
1993, Contraception
In a pilot study group of 25 women presenting in our clinic after exposure at ovulation to undesired pregnancy, endometrial suction by means of a Pipelle catheter was performed. Sixteen of the 25 women had proven fertility and 9 had never tried to conceive. The women were aged 18 to 38 years. Pathological dating of endometrial sampling verified that the patients were actually post-ovulation in all cases studied. hCG tests were performed 10 to 14 days after endometrial suction and all were negative. We conclude that endometrial suction in the luteal phase is a possible means of postcoital non-hormonal contraception, and we are currently expanding our study.

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The postcoital IUD as an effective continuing contraceptive method

Abstract

Contraception

Am. J. Obstet. Gynecol.

Postcoital hormonal contraception: uses, risks and abuses

Int. J. Gynaecol. Obstet.

Postcoital oestrogen or IUD?

IPFF Europe Regional Information Bulletin 8 n°