HomeIntroductionOverview of
the consortium
Report &
 Report & Recommendations
Back to Table of Contents
Advances in Methods of Emergency Contraception

Intra-uterine device as a method of Emergency Contraception
– Dr Wu ShangChun, China

Insertion of an intra-uterine device (IUD) shortly after unprotected intercourse provides an alternative emergency contraceptive method. It was first reported in1976. The copper-T IUD was inserted in 97 women within 5 days after unprotected intercourse. No pregnancy occurred within 3 months of the post-coital insertion of the IUD. In a review article by Fasoil et al, nine studies of IUD used in post-coital contraception were summarized. Information was available on a total of 879 women in only one failure was reported. The timing of insertion varied from one to ten days after unprotected intercourse. Data reported by Trussell et al showed that there are five published reports describing a total of eight pregnancies following 8400 post-coital IUD insertions. The failure rate was less than 0.1%. In summary, the available data show that insertion of a copper-IUD is a highly effective, safe and acceptable Emergency Contraception method.

To confirm the efficacy and acceptability of IUD in Emergency Contraception, a multi-centre trial has been carried out in China since 1998 with technical and financial support by WHO. A total of 1894 subjects were recruited. The one-year follow-up as just been completed. The preliminary results showed that no pregnancy occurred during the treatment cycle and no PID was reported up to one-year of follow-up. Only four pregnancies occurred after 2, 6, 8 and 12 months after insertion of the IUD. The advantages of IUD in Emergency Contraception were confirmed by the present study. The method was not only highly effective, but also provided up to 10 years of contraception. Failure due to further acts of unprotected intercourse during the treatment cycle, which happens quite frequently (it was 40% - 50% in our previous observations), could be avoided by using IUD.

Based on the above evidence, the currently revised IUD guideline has included the IUD as a method of Emergency Contraception. The parous women would be strongly recommended to insert IUD when they seek Emergency Contraception.

For proper screening and counselling, the following steps should be followed:

• According to the newly-published ‘Medical Eligibility Criteria for Contraceptive Use’ by WHO, the only contra-indication to IUD for emergency contraception is pregnancy. It is important to perform a urine pregnancy test by using a sensitive method to rule out pregnancy.

• Pelvic examination should be carefully performed by experienced providers to rule out PID or STI.

• The effectiveness of IUD insertion for Emergency Contraception as well as in the late use should not be overstated. The failure rate could be stated as about 1%. Subjects should be informed to terminate the unwanted pregnancy in case of failure.

• The common side-effects of pain and bleeding induced by IUD insertion should be informed to subjects properly.

• The subjects should be requested for regular follow-up visits, and be encouraged to come back if any problem occurs.

Back to Top   |   Back to Table of Contents

Introduction | Overview of the Consortium | Consensus Statements
Report & Recommendations | Future Guidelines | Training Manual
 For more information contact ec_india@hotmail.com | Credits