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Levonorgestrel IUD Noninferior for Emergency Contraception

THURSDAY, Jan. 28, 2021 -- For emergency contraception, a levonorgestrel intrauterine device (IUD) is noninferior to a copper IUD, according to a study published in the Jan. 28 issue of the New England Journal of Medicine.

David K. Turok, M.D., from the University of Utah in Salt Lake City, and colleagues conducted a randomized, noninferiority trial at six clinics in Utah involving women who sought emergency contraception after at least one episode of unprotected intercourse within five days before presentation. Participants were randomly assigned to receive either a levonorgestrel 52-mg or copper T380A IUD in a 1:1 ratio (355 and 356 participants, respectively). One-month outcome data were available for 317 and 321 participants, respectively.

The researchers found that pregnancy rates were 0.3 percent in the levonorgestrel IUD group and 0 percent in the copper IUD group in the modified intention-to-treat and per-protocol analyses; the results of both analyses were consistent with the noninferiority of levonorgestrel. Overall, 5.2 and 4.9 percent of those in the levonorgestrel and copper IUD groups, respectively, had adverse events resulting in seeking medical care in the first month after IUD placement.

"The incidence of pregnancy with the use of the levonorgestrel IUD for emergency contraception in this trial (0.3 percent; 95 percent confidence interval, 0.01 to 1.7) appears to compare favorably with that reported with oral emergency contraception (1.4 to 2.6 percent)," the authors write.

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