Intrauterine devices, or IUDs, are a safe and highly effective method of emergency contraception and should be routinely offered to patients, say researchers today.
A team led by Ms Kelly Cleland of Princeton University, New Jersey, USA, evaluated the evidence to date on the effectiveness of IUDs for emergency contraception.
In the journal Human Reproduction, they write that at least 36 per cent of pregnancies around the world are unintended, and nearly half of pregnancies in the US are unintended.
"Emergency contraception offers women an important strategy to prevent pregnancy after intercourse in cases of contraceptive accidents or non-use, or in situations of sexual violence," they write.
There are currently two forms of emergency contraception available, the "morning after pill" and IUDs, also known as the coil. IUDs have been studied for use as emergency contraception for at least 35 years.
The new study reviewed 42 studies carried out in six countries which included 7,034 women fitted with eight different types of IUD.
The delay between intercourse and IUD insertion was up to ten days, most being used within five days. The overall pregnancy rate was 0.09 per cent, compared with one to three per cent for the morning after pill.
"IUDs are a highly effective method of contraception after unprotected intercourse," the authors write. "Because they are safe for the majority of women, highly effective and cost-effective when left in place as ongoing contraception, whenever clinically feasible IUDs should be included in the range of emergency contraception options."
But they add that the results cannot be more specific as they are limited by a lack of information on cycle day of intercourse and IUD type.
The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience, Cleland, K. et al. Human Reproduction May 9 2012 doi:10.1093/humrep/des140
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