The Copper IUD is the most effective form of emergency contraception (EC).

The Copper IUD is nearly 100% effective as emergency contraception. In comparison, EC pills have been shown to be less than 90% effective. However, the majority of patients requesting EC in the US are not offered the Copper IUD as an option.

An important benefit of the Copper IUD is that it can also work as a highly effective birth control for patients who desire ongoing contraception.

Following insertion as EC, the Copper IUD can continue to be used as a regular birth control method for up to 12 years. One study found that patients who opted for the IUD as EC vs EC pills were more likely to be using an effective contraceptive method six months later. Researchers have found one year continuation rates following Copper IUD insertion to be about 80%. Another study found that patients who chose an IUD for EC had half the number of pregnancies within a year than patients who chose EC pills. 

The Copper IUD as EC is almost 100% effective.

Almost any patient can get an IUD.

  • The Copper IUD can be inserted up to 5 days after unprotected intercourse.
  • The Copper IUD is the most effective option for patients of any weight. Levonorgestrel pills, like Plan B One-Step®, may be less effective if a patient weighs over 165 pounds, and the ulipristal acetate pill, ella®, may be less effective if a patient weighs over 195 pounds. The Copper IUD maintains effectiveness in all weight ranges.

Emergency Contraception chart

Download or order free copies of this chart and other tools and materials here
 

How can a clinic begin offering the Copper IUD as EC?

Provider and staff awareness and education about the IUD as EC is an important initial step to offering patients this EC method. Several studies found that many providers, particularly those outside of reproductive health specialties, were unaware that the Copper IUD was an option for emergency contraception and as a result, that providers were less likely to offer IUDs as EC compared to EC pills, even if they already provided the copper IUD in clinic.

Potential barriers to offering the Copper IUD as EC routinely in clinic include:

  • Potentially high up-front cost to the patient or clinic;
  • Lack of providers trained in the insertion procedure;
  • Concerns about unexpected insertion procedures disrupting clinic flow.

If a patient is interested in getting a Copper IUD as EC, the clinic should try to place the IUD that same day, as returning to the clinic can pose a significant challenge, and many patients do not return for a placement visit.

 

Video: Using the Copper IUD as Emergency Contraception

We designed the following video for providers and clinics interested in learning more about using the Copper IUD as EC. The video includes information on patient eligibility as well as suggestions on incorporating the Copper IUD as EC into clinic practice.

 

 

Selected literature for further reading:

  1. Batur P, Cleland K, Mcnamara M, Wu J, Pickle S. Emergency contraception: A multispecialty survey of clinician knowledge and practices. Contraception 93(2):145-15, 2016.
  2. Envall N, Kofoed NG, Kopp-Kallner H. Use of effective contraception 6 months after emergency contraception with a copper intrauterine device or ulipristal acetate - a prospective observational cohort study. Acta Obstetricia et Gynecologica Scandinavica 95(8):887-893, 2016.
  3. Kohn JE, Nucatola DL. EC4U: results from a pilot project integrating the copper IUC into emergency contraceptive care. Contraception 94(1):48-51, 2016.
  4. Sanders JN, Howell L, Saltzman HM, Schwarz EB, Thompson I, Turok DK. Unprotected intercourse in the two weeks prior to requesting emergency intrauterine contraception. American Journal of Obstetrics and Gynecology, 2016.
  5. Sanders JN, Turok DK, Royer PA, Thompson IS, Gawron LM, Storck KE. One-year continuation of copper or levonorgestrel intrauterine devices initiated at the time of emergency contraception. Contraception. 2017 Aug;96(2):99-105.
  6. Schubert FD, Bishop ES, Gold M. Access to the copper IUD as post-coital contraception: results from a mystery caller study. Contraception, 2016.
  7. Trussell J, Raymond EG, Cleland K. Emergency contraception: A last chance to prevent unintended pregnancy. Contemporary Readings in Law and Social Justice 62(2):7-38, 2016.
  8. Baird AS, Trussell J, Webb A. Use of ulipristal acetate and levonorgestrel for emergency contraception: a follow-up study. Journal of Family Planning and Reproductive Health Care, 41:116-121, 2015.
  9. Batur P, Cleland K, McNamara M, Wu J, Pickle S; EC Survey Group. Emergency contraception: A multispecialty survey of clinician knowledge and practices. Contraception, 2016 Feb;93(2):145-52.
  10. Raymond EG, Cleland K. Clinical practice: Emergency contraception. New England Journal of Medicine 372(12):1342-1348, 2015.
  11. Schwarz EB, Papic M, Parisi SM, Baldauf E, Rapkin R, Updike G. Routine counseling about intrauterine contraception for women seeking emergency contraception. Contraception 90(1):66-71, 2014.
  12. Turok DK, Jacobson JC, Dermish AI, et al. Emergency contraception with a copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates. Contraception 89(3):222-8, 2014.
  13. Turok DK, Godfrey EM, Wojdyla D, Dermish A, Torres L, Wu SC. Copper T380 intrauterine device for EC: highly effective at any time in the menstrual cycle. Human Reproduction 28(10):2672-6, 2013.
  14. Belden P, Harper CC, Speidel JJ. The copper IUD for emergency contraception, a neglected option. Contraception 85:338-339, 2012.