Takaisin Tulosta

Levonorgestrel intrauterine device for emergency contraception

Evidence summaries
Heidi Alenius
Last reviewed as up-to-date 14.11.2023Latest change 14.11.2023

Level of evidence: D

Levonorgestrel intrauterine system (LNG-IUS) might possibly be effective for emergency contraception and might possibly be noninferior to the copper IUD, but the evidence is insufficient.

The certainty of the evidence is downgraded by study quality (imbalance in baseline characteristics) and by imprecise results (very few outcome events).

Summary

In a multicentre trial «Turok DK, Gero A, Simmons RG et al. Levonorgestrel...»1 711 women (age 18- 35) who sought emergency contraception after at least one episode of unprotected intercourse within 5 days were randomly assigned in a 1:1 ratio to receive a levonorgestrel 52-mg IUD (LNG-IUD) or a copper T380A IUD. 655 women received assigned intervention. Of these, 590 participants had a 1-month urine pregnancy test. Participants were followed up 6 months. Pregnancy rates were 1 in 317 (0.3%; 95% CI 0.01 to 1.7) in the LNG-IUD group and 0 in 321 (0%; 95% CI 0 to 1.1) in the copper IUD group; the between-group absolute difference in both analyses was 0.3 percentage points (95% CI −0.9 to 1.8), consistent with the noninferiority of the LNG-IUD to the copper IUD. Adverse events resulting in participants seeking medical care in the first month occurred in 5.2% of in the LNG-IUD group and 4.9% of those in the copper IUD group.

A Cochrane review «Progestin intrauterine devices versus copper intrauterine devices for emergency contraception»1 «...»2 included one study, the above mentioned trial.

References

  1. Turok DK, Gero A, Simmons RG et al. Levonorgestrel vs. Copper Intrauterine Devices for Emergency Contraception. N Engl J Med 2021;384(4):335-344. «PMID: 33503342»PubMed
  2. Ramanadhan S, Goldstuck N, Henderson JT et al. Progestin intrauterine devices versus copper intrauterine devices for emergency contraception. Cochrane Database Syst Rev 2023;2(2):CD013744. «PMID: 36847591»PubMed