An Indian experience with intrauterine device-CuT 200B and oral levonorgestrel (LNG) as emergency contraception

An Indian experience with intrauterine device-CuT 200B and oral

levonorgestrel (LNG) as emergency contraception

L.N. Gaur, Malabika Roy, N.K. Gupta, C. Shekhar, S. Datey, N.C.

Saxena Division of Reproductive Health and Nutrition, Indian Council of

Medical Research (ICMR), New Delhi, India

Objectives: To study the profile and perception of women seeking

emergency contraception (EC) and to evaluate the efficacy & side effects of

0.75mg oral LNG (2 doses) and CuT200 B for EC.

Design and Methods: Women requesting for EC after single act of

unprotected intercourse in the current menstrual cycle were offered 0.75 mg LNG

(2 doses) 12 hours apart within 72 hours and CuT 200B inserted within 120 hours

of unprotected intercourse as EC. A total of 632 women who fulfilled the

selection criteria and gave informed written consent were enrolled in the study

at 8 Human Reproduction Research Centers of ICMR. The subjects were followed up

at one week after the expected date of next menstrual bleeding to elicit the

information on pregnancy, side effects and perception about EC. The efficacy was

assessed by crude pregnancy rate as well as percent pregnancy averted.

Results: Of the 632 acceptors, 46.8% sought EC due to non-use of any

family planning method, 10.8% forgot to use condom, 26.1% women sought due to

condom breakage /slippage, 6.8% sought due to IUD expulsion/displacement. Forced

sex was the reason given by only 0.9% of women. The average age and parity were

27.3 years and 2.2 respectively. Nulliparous/unmarried/ widow constituted 5.7 %

of women. The relative acceptances of the two methods were 36.1% of IUD and

63.9% of LNG. Majority (82.2% and 73.2%) of women sought LNG and IUD within 48

and 72 hrs respectively. Six pregnancies were reported in the LNG group (3 user

failure and 3 method failure) giving a typical use failure rate of 1.66 %. The

percent pregnancies averted with LNG was 76.9 which is comparable with the WHO

study which reported a failure rate of 1.7 % and percent pregnancy averted as

77.0 with the LNG 0.75 mg two dose schedule. There was no pregnancy reported

with CuT 200B in the present study. Side effects with LNG were nausea, headache

and dizziness that ranged between 10–14% and with IUD low abdominal pain

(49.1%) and irregular bleeding (13.2%) were the major complaints. Women’s

perception of EC in the study indicated that majority (93.2%) would like to

consult a doctor before use. 62% women expressed that adolescents should be made

aware of EC.

Conclusions: 0.75 mg LNG (two doses) is an efficacious and acceptable

method for EC as the pregnancy rate was 1.66% and it averted 77.0% of the

excepted pregnancies in Indian women on typical use. CuT 200B in the study

averted all the expected pregnancies. Most women in the study indicated

preference of availing LNG pills from a health facility after consulting a


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