January 27, 2021
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Health
Levonorgestrel IUD as good as copper IUD as an emergency contraceptive
Source / Disclosure
Disclosure: Turok reports that he has received a research grant / contract from the Eunice Kennedy Schreiber National Institute of Child Health Development and is a National Principal Investigator for two Phase 3 FDA studies assessing new IUDs. See the survey for relevant financial disclosures of all other authors.
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Levonorgestrel’s intrauterine device was not inferior to copper IUD as an emergency contraceptive, New England Journal of Medicine..
“Researchers and clinicians have long known that copper IUDs are very effective in emergency contraception.” David K. Turlock, MD, An associate professor of obstetrics and gynecology at the University of Utah told Healio Primary Care. “But the hormone IUD (levonorgestrel 52 mg IUD) has distinct characteristics that many people like.”
For example, he said levonorgestrel IUDs reduce seizures and menstrual bleeding.
“Until now, we didn’t know if levonorgestrel IUDs would work for emergency contraception. Now we know,” continued Turok. “In the first study of this kind, a team from the University of Utah Health Planning Parents and Children Association found that the hormone IUD was comparable to the copper IUD for use as an emergency contraceptive device.”
To evaluate Effectiveness of both IUDs As an emergency contraceptive, Turok et al. Conducted a randomized, non-inferiority trial in women seeking an emergency contraceptive after at least one unprotected sexual intercourse that agreed to place an IUD in the last five days. Did. From August 2016 to December 2019, women aged 18-35 years were enrolled in the study from six Utah clinics.
Participants showed a negative urinary pregnancy test prior to placing the IUD, and participants included in the study were randomly assigned to receive levonorgestrel or copper IUDs. The researchers scheduled a one-month follow-up visit after the placement of the IUD and conducted a home pregnancy test on the woman for use the day before the appointment.
Participants were sent follow-up surveys at 3 and 6 months, and researchers reviewed electronic health record data to assess pregnancy status and IUD use during follow-up. The woman received a $ 10 gift card to complete the follow-up survey and a $ 30 gift card to attend the follow-up appointment.
A total of 317 women were randomly assigned to receive the levonorgestrel IUD, and 356 women were assigned to the copper IUD. Among them, 290 women who received a levonorgestrel IUD and 300 women who received a copper IUD had a one-month urine pregnancy test.
In a modified ITT analysis and protocol-by-protocol analysis, Turok et al. Found that the levonorgestrel group had a pregnancy rate of 1 in 317 (0.3%; 95% CI, 0.01-1.7). For women in the copper IUD group, the pregnancy rate was 0 out of 321 (0%; 95% CI, 0-1.1).
In both analyzes, the absolute difference between the groups was 0.3 percentage points (95% CI, 0.9 to 1.8).
Of the participants, 5.4% of the levonorgestrel IUD group and 4.9% of the copper IUD group sought medical care for adverse events after IUD placement.
The results suggest that levonorgestrel IUD was not inferior to copper IUD as an emergency contraceptive after unprotected sexual intercourse within the last five days, according to researchers.
Turok said physicians need to start offering this levonorgestrel IUD as an emergency contraceptive, and both PCPs and patients need to be aware of this as an emergency contraceptive option.
” New contraceptive When options become available, the interaction of patient demands with the knowledge of the provider facilitates care for everyone, “he said. “The next step in research on this topic is to investigate how to communicate that the hormone IUD is an effective emergency contraception option to those considering the use of emergency contraception, and to provide care by providing this service. Educating providers to improve. “
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