<p>The efficacy of intrauterine devices for emergency contraception and beyond: a systematic review update</p>

Abstract

BackgroundThe copper intrauterine device (IUD) is a very effective form of emergency contraception. The failure rate is about 0.1%. IUDs are also very cost-effective when used as long acting-reversible contraception (LARC). The purpose of this review is to attempt to confirm these findings.MethodsThe references for this study were generated 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 emergency contraception study, articles with a defined population who were followed up until outcome were eligible. Women who were adequately followed for at least 6 months were included in the long term arm of the study.ResultsThere were 18 (of 228) studies which met our selection criteria and were conducted in five countries, between August 2011 and January 2018. There were 1720 insertions of seven types of copper IUD with a failure rate of 0.12%. The maximum time from intercourse to IUD insertion was 14 days. The discontinuation rate at 12 months was over 20% in the long term studies.ConclusionThere are now a combined total of 8550 reported insertions from two reviews with 8 pregnancies and a failure rate of 0.093%. Copper IUDs remain an effective form of emergency contraception, for which they are under-promoted. The major limitation of the studies is the lack of data relating unprotected intercourse to the day of the cycle.

Emergency contraception from historical myth to modern reality: a historical timeline and updated interpretation

“…While there are anecdotal reports of pregnancy with copper IUDs in western countries 80 there are at present no reports of a pregnancy in a single copper IUD for EC study in a western country following two extensive systematic reviews (8,550 insertions and 12 pregnancies, all from Egypt or China). 81,82 Both reviews showed a pregnancy rate of about 0.1%. Only the Multiload IUDs (MLCu 250 and MLCu 375, Multilan SA, Fribourg, Switzerland) and GyneFix (Contrel, Ghent, Belgium) IUDs have an official indication for use as EC.…”

Perfil epidemiológico y prácticas en salud reproductiva de la interrupción voluntaria de embarazo en Salamanca

“…Los mismos autores en la versión de 2012 y posteriores revisiones sistemáticas, afirman que el DIU de cobre es el método más efectivo (50-52). La tasa de fallo publicada como método de AU es del 0'1% (53). Sin embargo, no es de acceso universal por la falta de infraestructuras ni es la opción más adecuada para mujeres en riesgo de infecciones de transmisión sexual (ITS).…”

Rethinking referral pathways: qualitative evaluation of general practice networks to increase access to intrauterine contraception

“…Pathway C was specific to Emergency Contraception (EC) copper IUDs and was developed in recognition of the limited use, despite its efficacy. 12 , 13 All pathways guided patients back to the referring GP. The formalized referral pathways aimed to (i) create effective IUD access pathways; (ii) facilitate communication and trust between inserters and the referring GPs; (iii) minimize documentation time by providing referral letter templates and information leaflets for modification as required to be incorporated into GP practice software; and (iv) develop a community of practice to support peer education.…”