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ORIGINAL RESEARCH |
From Ibis Reproductive Health, Cambridge, Massachusetts; Abacus Centre for Contraception and Reproductive Health, Liverpool, United Kingdom; Planned Parenthood of Greater Iowa, Des Moines, Iowa; Glasgow Centre for Family Planning and Sexual Health, Glasgow, United Kingdom; and Office of Population Research, Princeton University, Princeton, New Jersey.
Address reprint requests to: Charlotte Ellertson, President, Ibis Reproductive Health, 2 Brattle Square, Cambridge, MA 02138; E-mail: cellertson{at}ibisreproductivehealth.org.
OBJECTIVE: Current protocols state that the Yuzpe regimen of emergency contraception can be initiated up to 72 hours after unprotected intercourse. The purpose of this study was to determine whether the window for emergency hormonal contraception can be extended to 120 hours.
METHODS: In an observational study, we tracked 111 women who requested emergency contraception between 72 and 120 hours after unprotected sex but refused postcoital copper intrauterine devices (IUDs), preferring instead the Yuzpe regimen. We compared failure rates for this group with rates among 675 otherwise similar women who started the same therapy within 72 hours.
RESULTS: Both perfect use (1.9%) and typical use (3.6%) failure rates were low among women presenting between 72 and 120 hours after unprotected intercourse. These rates did not statistically differ from failure rates for the standard Yuzpe regimen (2.0% during perfect use and 2.5% during typical use). Our small sample size of 111, however, gave us just 25% power to detect a doubling in the failure rates (2% to 4%) and 59% power to detect a tripling in the failure rates (2% to 6%).
CONCLUSION: The 72-hour cutoff for the Yuzpe regimen of emergency contraception appears needlessly restrictive. Women who request this therapy more than 72 hours after unprotected sex should be allowed to receive it, particularly if they decline postcoital insertion of a copper IUD and would otherwise have no options for reducing pregnancy risk.
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 IN BRIEF BMJ, June 12, 2003; 326(7402): 1282 - 1282. [Full Text]
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C. Ellertson, A. Webb, K. Blanchard, A. Bigrigg, S. Haskell, T. Shochet, and J. Trussell Modifying the Yuzpe Regimen of Emergency Contraception: A Multicenter Randomized Controlled Trial Obstet. Gynecol., June 1, 2003; 101(6): 1160 - 1167. [Abstract] [Full Text] [PDF]
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