title: Preference for and efficacy of oral levonorgestrel for emergency contraception with concomitant placement of a levonorgestrel IUD: a prospective cohort study.
abstract: We assessed intrauterine device (IUD) preference among women presenting for emergency contraception (EC) and the probability of pregnancy among concurrent oral levonorgestrel (LNG) plus LNG 52 mg IUD EC users.
  
  
  
  We offered women presenting for EC at a single family planning clinic the CuT380A IUD (copper IUD) or oral LNG 1.5 mg plus the LNG 52 mg IUD. Two weeks after IUD insertion, participants reported the results of a self-administered home urine pregnancy test. The primary outcome, EC failure, was defined as pregnancies resulting from intercourse occurring within five days prior to IUD insertion.
  
  
  
  One hundred eighty-eight women enrolled and provided information regarding their current menstrual cycle and recent unprotected intercourse. Sixty-seven (36%) chose the copper IUD and 121 (64%) chose oral LNG plus the LNG IUD. The probability of pregnancy two weeks after oral LNG plus LNG IUD EC use was 0.9% (95% CI 0.0-5.1%). The only positive pregnancy test after treatment occurred in a woman who received oral LNG plus the LNG IUD and who had reported multiple episodes of unprotected intercourse including an episode more than 5 days prior to treatment.
  
  
  
  Study participants seeking EC who desired an IUD preferentially chose oral LNG 1.5 mg with the LNG 52 mg IUD over the copper IUD. Neither group had EC treatment failures. Including the option of oral LNG 1.5 mg with concomitant insertion of the LNG 52 mg IUD in EC counseling may increase the number of EC users who opt to initiate highly effective reversible contraception.
  
  
  
  Consideration should be given to LNG IUD insertion with concomitant use of oral LNG 1.5 mg for EC. Use of this combination may increase the number of women initiating highly effective contraception at the time of their EC visit.
authors.affiliation: University of Utah, Department of Obstetrics and Gynecology, 30 North 1900 East, Room 2B200, Salt Lake City, UT 84132-2209. Electronic address: david.turok@hsc.utah.edu.
authors.forename: David K
authors.initials: DK
authors.lastname: Turok
authors.affiliation: University of Utah, Department of Obstetrics and Gynecology, 30 North 1900 East, Room 2B200, Salt Lake City, UT 84132-2209.
authors.forename: Jessica N
authors.initials: JN
authors.lastname: Sanders
authors.affiliation: University of Utah, Department of Obstetrics and Gynecology, 30 North 1900 East, Room 2B200, Salt Lake City, UT 84132-2209.
authors.forename: Ivana S
authors.initials: IS
authors.lastname: Thompson
authors.affiliation: University of Utah, Department of Obstetrics and Gynecology, 30 North 1900 East, Room 2B200, Salt Lake City, UT 84132-2209.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Royer
authors.affiliation: University of Utah, Department of Obstetrics and Gynecology, 30 North 1900 East, Room 2B200, Salt Lake City, UT 84132-2209.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Eggebroten
authors.affiliation: University of Utah, Department of Obstetrics and Gynecology, 30 North 1900 East, Room 2B200, Salt Lake City, UT 84132-2209.
authors.forename: Lori M
authors.initials: LM
authors.lastname: Gawron
mesh_terms: D000293:Adolescent; D000328:Adult; D044363:Contraception, Postcoital / Q000379:methods*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000706:statistics & numerical data*; D007436:Intrauterine Devices, Medicated / Q000706:statistics & numerical data*; D016912:Levonorgestrel / Q000008:administration & dosage*; D008597:Menstrual Cycle / Q000187:drug effects; D057240:Patient Preference / Q000706:statistics & numerical data*; D011247:Pregnancy; D011446:Prospective Studies; D014589:Utah; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
keywords: Emergency contraception; copper IUD; levonorgestrel IUD; pregnancy