Extending the time limit for starting the Yuzpe regimen of emergency contraception to 120 hours.
OBJECTIVE
Current protocols state that the Yuzpe regimen of emergency contraception can be initiated up to 72 hours after unprotected intercourse. The purpose of this study was to determine whether the window for emergency hormonal contraception can be extended to 120 hours.


METHODS
In an observational study, we tracked 111 women who requested emergency contraception between 72 and 120 hours after unprotected sex but refused postcoital copper intrauterine devices (IUDs), preferring instead the Yuzpe regimen. We compared failure rates for this group with rates among 675 otherwise similar women who started the same therapy within 72 hours.


RESULTS
Both perfect use (1.9%) and typical use (3.6%) failure rates were low among women presenting between 72 and 120 hours after unprotected intercourse. These rates did not statistically differ from failure rates for the standard Yuzpe regimen (2.0% during perfect use and 2.5% during typical use). Our small sample size of 111, however, gave us just 25% power to detect a doubling in the failure rates (2% to 4%) and 59% power to detect a tripling in the failure rates (2% to 6%).


CONCLUSIONS
The 72-hour cutoff for the Yuzpe regimen of emergency contraception appears needlessly restrictive. Women who request this therapy more than 72 hours after unprotected sex should be allowed to receive it, particularly if they decline postcoital insertion of a copper IUD and would otherwise have no options for reducing pregnancy risk.
Ellertson
Charlotte
C
Ibis Reproductive Health, Cambridge, Massachusetts 02138, USA. cellertson@ibisreproductivehealth.org
Evans
Margaret
M
Ferden
Sue
S
Leadbetter
Clare
C
Spears
Aileen
A
Johnstone
Karen
K
Trussell
James
J
D000293:Adolescent; D000328:Adult; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage; D003281:Contraceptives, Postcoital / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D009644:Norgestrel / Q000008:administration & dosage; D011247:Pregnancy; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D017211:Treatment Failure
D003277:Contraceptives, Oral, Combined; D003281:Contraceptives, Postcoital; D009644:Norgestrel; D004997:Ethinyl Estradiol