Unprotected intercourse in the 2 weeks prior to requesting emergency intrauterine contraception

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

“…These two studies limited provision of an IUD to 3 days, probably to maintain similarity to the oral comparison group. All of the English language studies followed the same protocol (limiting insertion to 120 hrs) except the study by Sanders and colleagues10 which included subjects with multiple episodes of unprotected sex in the cycle pushing the length of time from first exposure to 6–14 days in some instances, provided a high sensitivity pregnancy test was negative.…”

“…In one study the LNG-IUS 52mg was given at the same time as oral LNG3 and there is no reason why this approach cannot be used together with LNG-IUS 13.5mg (Skyla © /Jaydess © ) or LNG-IUS 19.5mg (Kyleena © ) which may be more appropriate in nulliparous and uniparous women 32. While consideration has been given to using UPA as oral emergency contraception prior to providing an LNG releasing IUD10 its role as a partial progestin agonist-antagonist may possibly interfere with the early action of the LNG-IUS, especially its pronounced effect on cervical mucus,33 in the same way that it influences the effect of desorgestrel containing oral contraceptives 34…”

“…Since the previous review methods of analysis have become more detailed and some papers had been subjected to secondary analysis 3. Great care was taken to ensure that data were not used more than once, but data from the secondary10 and in one instance tertiary analysis11 has been referred to where of interest. All the search and extracted data has been uploaded to the Open Science Framework (OFS) data repository (https://osf.io/84grx/files/).…”

Intrauterine mepivacaine instillation for pain relief during intrauterine device insertion in nulliparous women: a double-blind, randomized, controlled trial

“…This result contradicts assumptions about higher continued use among those opting for LNG-IUS compared to Cu-IUD for EC. The same study reported three pregnancies in the LNG-IUS + LNG ECP group compared to no pregnancies in the Cu-IUD group, a result that needs to be further evaluated since 43% of study participants reported two or more UPSIs in the last two weeks before IUD insertion (55). One of the reported pregnancies was not detected at the insertion visit, and one was caused by a missed IUD expulsion, ending up in one pregnancy during current IUD use (54).…”

Copper intrauterine device placement 6–14 days after unprotected sex

“…We previously reported that 40 of 176 (23%) participants seeking an IUD for emergency contraception (EC) who reported unprotected intercourse in the previous 5 days also reported unprotected intercourse in the prior 6 -14 days [8]. As women reporting multiple episodes of unprotected intercourse in a single menstrual cycle are at increased risk of unintended pregnancy compared to those with a single episode of unprotected intercourse [9], such women may have a particular need for highly effective emergency contraception.…”