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Levonorgestrel vs. Copper Intrauterine Devices for Emergency Contraception

David K. Turok, M.D., Alexandra Gero, M.P.H., Rebecca G. Simmons, Ph.D., Jennifer E. Kaiser, M.D., Gregory J. Stoddard, M.P.H., Corinne D. Sexsmith, M.S., Lori M. Gawron, M.D., and Jessica N. Sanders, Ph.D.

JAN. 28, 2021

DOI:10.1056/NEJMoa2022141

Among the 355 participants randomly assigned to receive levonorgestrel IUDs and 356 assigned to receive copper IUDs, 317 and 321, respectively, received the interventions and provided 1-month outcome data. Of these, 290 in the levonorgestrel group and 300 in the copper IUD group had a 1-month urine pregnancy test. In the modified intention-to-treat and per-protocol analyses, pregnancy rates were 1 in 317 (0.3%; 95% confidence interval [CI], 0.01 to 1.7) in the levonorgestrel 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 levonorgestrel IUD to the copper IUD. Adverse events resulting in participants seeking medical care in the first month after IUD placement occurred in 5.2% of participants in the levonorgestrel IUD group and 4.9% of those in the copper IUD group.

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