Intrauterine Devices: Separating Fact From Fallacy

, Magee-Womens Hospital, University of Pittsburgh School of Medicine

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Use as Emergency Contraception

In 1976, Lippes and coworkers[36] first reported the use of a copper-containing IUD for emergency contraception. Obviously, postcoital insertion would not inhibit sperm capacitation or migration; therefore, it is very likely that the IUD acts as a postcoital contraceptive by preventing implantation. It is not well understood whether the copper acts as a toxic agent to an early embryo, whether the inflammation creates an environment unsui for implantation, or both. Regardless of the exact mechanism of action, a copper-containing IUD appears to be very effective, with only 1 failure reported in the world literature of 879 cases.[37]

The copper-containing IUD can be inserted up to 7 days after unprotected intercourse to provide postcoital contraception.[38,39,40,41] This is 4 days longer than the window for hormonal methods and provides a viable option for women who delay in presenting for treatment. However, this method is only useful for a woman who is a good IUD candidate and who plans to continue using the IUD for regular contraception. For a woman who requests emergency contraception and is a victim of sexual assault, has a new partner, or has multiple partners, an IUD would not be a reasonable option.

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