Background
Each year, about 44 million pregnancies in the whole world, end in abortion. The usual response to this problem has been contraception or primary prevention, backed up by induced abortion. Emergency contraception is the use of a drug or device to prevent pregnancy after unprotected intercourse. Interest in the development of alternative regimens has led to trials of the progestogen LNG, the anti-gonadotropin danazol, and the anti-progestins mifepristone and ulipristal acetate (UPA). These methods are recommended for use within 72 hours of unprotected intercourse although LNG and mifepristone had been tested up to 120 hours (five days) for research purposes. The postcoital insertion of a copper intrauterine device (Cu-IUD) is an option that can be used up to five days after the estimated time of ovulation and can be left in the uterus as a long-term regular contraceptive method. Information on the comparative effectiveness, safety and convenience of an emergency contraceptive method is crucial for reproductive healthcare providers and the women they serve.
Key findings
- The copper intrauterine device (IUD) is the most effective emergency contraceptive method and is the only emergency contraceptive method that provides ongoing
contraception.
- Where readily available, mifepristone should be the first choice for hormonal emergency contraception ( EC). Ulipristal acetate (UPA) seemed slightly more effective than levonorgestrel ( LNG) and can be an alternative where this medicine is accessible and affordable.
- Emergency Contraception (EC) should be offered to all women requesting this service even though it should not be used routinely.