Quick Start of Highly Effective Contraception

Women seeking emergency contraception (EC) frequently report multiple recent episodes of
unprotected sex. Although high sensitivity urine pregnancy tests effectively rule-out
pregnancy resulting from sex that occurred more than 14 days ago, clinicians are frequently
concerned that pregnancy may result from unprotected sex that occurred <14 days prior to IUD
placement. Placement of a copper IUD within 5 days of unprotected sex is a highly effective
form of EC. Among 52 Chinese women who reported unprotected intercourse 5-7 days prior to
copper IUD insertion, no pregnancies occurred. However, the effectiveness of the copper IUD
when unprotected sex occurs 7-14 days prior to IUD placement is unknown. Intrauterine
pregnancies rarely occur with a copper IUD in place. As some clinicians are concerned about
injuring a pregnancy that occurs with an IUD in place, women who have had unprotected sex
7-14 days prior to requesting IUD placement are typically told they must use another, less
effective, contraceptive for 2+ weeks and then return to obtain an IUD. To remove this
barrier to emergency placement of a copper IUD, we propose to study rates of pregnancy when a
copper IUD is placed "any time a urine pregnancy test is negative." We believe that
simplifying guidance regarding the recommended timing of copper IUD placement has the
potential to significantly increase the number of women offered "same-day" IUD service.

Inclusion Criteria:

- Women between the ages of 15 and 45 years who request injectable, subdermal, or
intrauterine contraception, 6-14 days after having unprotected intercourse.

Exclusion Criteria:

- History of tubal ligation or hysterectomy.

- Positive urine pregnancy test