Emergency contraception with Multiload Cu-375 SL IUD: a multicenter clinical trial

The objectives of the present study were to evaluate the efficacy and side effects and the benefits and limitations of inserting Multiload intrauterine device (IUD) for emergency contraception. A total of 1013 women requesting emergency contraception was recruited, among whom 843 were parous women and 170 nulliparous women. Multiload Cu-375 SL IUD was inserted within 120 h after unprotected intercourse. A urine test for pregnancy was performed before IUD insertion to rule out pregnancy. Participants were followed-up until 1 week after the expected day of the next menstruation. Pregnancy test or ultrasound scanning were performed if menstruation did not return. Efficacy of preventing unplanned pregnancy was calculated. Efficacy and side effects were compared between the parous and nulliparous groups. The results showed that there were two pregnancies, one in each group. The pregnancy rate was 0.2 per 100 women. The efficacy rate of preventing unwanted pregnancy in the parous group was 98.1% and in the nulliparous group 92.4%. The difference was not significant. Removal of IUD because of pain and bleeding was 2.5% in parous women, but was more in the nulliparous group (10.6%). After the return of menstruation, 95.7% of parous women and 80% of nulliparous women maintained the IUD for contraception. There were two complete expulsions and three partial expulsions of the IUD, but there was no significant changes in menstruation and bleeding pattern, nor was infection or trauma observed. It was concluded that IUD insertion is a safe and effective method for emergency contraception for both parous and nulliparous women. One of the advantages of using an IUD is its long-term contraceptive effect, if the women prefer to continue its use.