title: Emergency contraception with a copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates.
abstract: OBJECTIVE
  We investigated the 1-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 intrauterine device (IUD) or oral levonorgestrel (LNG) for EC.
  
  
  METHODS
  This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC.
  
  
  RESULTS
  Of the 542 women who presented for EC, agreed to participate in the trial and met the inclusion criteria, 215 (40%) chose the copper IUD and 327 (60%) chose oral LNG. In the IUD group, 127 (59%) were nulligravid. IUD insertion failed in 42 women (19%). The 1-year follow-up rate was 443/542 (82%); 64% of IUD users contacted at 1 year still had their IUDs in place. The 1-year cumulative pregnancy rate in women choosing the IUD was 6.5% vs. 12.2% in those choosing oral LNG [hazard ratio (HR) 0.53, 95% confidence interval (CI): 0.29-0.97, p=.041]. By type of EC method actually received, corresponding values were 5.2% for copper IUD users vs. 12.3% for oral LNG users (HR 0.42, 95% CI: 0.20-0.85, p=.017). A multivariable logistic regression model controlling for demographic variables demonstrates that women who chose the IUD for EC had fewer pregnancies in the following year than those who chose oral LNG (HR 0.50, 95% CI: 0.26-0.96, p=.037).
  
  
  CONCLUSIONS
  One year after presenting for EC, women choosing the copper IUD for EC were half as likely to have a pregnancy compared to those choosing oral LNG.
  
  
  CONCLUSIONS
  Compared to EC users who choose oral levonorgestrel, those who select the copper IUD have lower rates of pregnancy in the next year. Greater use of the copper IUD for EC may lower rates of unintended pregnancy in high-risk women.
authors: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84132, USA. Electronic address: David.Turok@hsc.utah.edu.
authors: David K
authors: DK
authors: Turok
authors: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84132, USA.
authors: Janet C
authors: JC
authors: Jacobson
authors: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84132, USA.
authors: Amna I
authors: AI
authors: Dermish
authors: Department of Family and Preventive Medicine, Division of Public Health, University of Utah, Salt Lake City, UT 84108, USA.
authors: Sara E
authors: SE
authors: Simonsen
authors: Utah Fertility Center, Pleasant Grove, UT 84062, USA.
authors: Shawn
authors: S
authors: Gurtcheff
authors: Division of Epidemiology, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA.
authors: Molly
authors: M
authors: McFadden
authors: University of Utah College of Nursing, Salt Lake City, UT 84132, USA.
authors: Patricia A
authors: PA
authors: Murphy
mesh_terms: D000293:Adolescent; D000328:Adult; D044363:Contraception, Postcoital / Q000379:methods*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007435:Intrauterine Devices, Copper; D016912:Levonorgestrel / Q000008:administration & dosage*; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D003280:Contraceptives, Oral, Synthetic; D016912:Levonorgestrel
keywords: Emergency contraception; IUD; Oral levonrgestrel; Pregnancy