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Appendix F

Classifications for Copper Intrauterine Devices for Emergency Contraception


A copper IUD (Cu-IUD) can be used within 5 days of unprotected intercourse as an emergency contraceptive. However, when the time of ovulation can be estimated, the Cu-IUD can be inserted beyond 5 days after intercourse, if necessary, as long as the insertion does not occur >5 days after ovulation.

The eligibility criteria for interval Cu-IUD insertion also apply for the insertion of Cu-IUDs as emergency contraception (Box). Cu-IUDs for emergency contraception do not protect against sexually transmitted infections (STIs) or human immunodeficiency virus (HIV).

BOX. Categories for Classifying Cu-IUDs as Emergency Contraception

1 = A condition for which there is no restriction for the use of the contraceptive method.

2 = A condition for which the advantages of using the method generally outweigh the theoretical or proven risks.

3 = A condition for which the theoretical or proven risks usually outweigh the advantages of using the method.

4 = A condition that represents an unacceptable health risk if the contraceptive method is used.


TABLE. Classifications for copper intrauterine devices for emergency contraception*

Condition

Category

Clarifications/Evidence/Comments

Pregnancy

4

Clarification: IUD use is not indicated during pregnancy and should not be used because of the risk for serious pelvic infection and septic spontaneous abortion.

Rape

a. High risk for STI

3

Comment: IUDs do not protect against STI/HIV or PID. Among women with chlamydial infection or gonorrhea, the potential increased risk for PID with IUD insertion should be avoided. The concern is less for other STIs.

b. Low risk for STI

1

* Abbreviations: IUD = intrauterine device; Cu-IUD = copper IUD; STI = sexually transmitted infection; HIV = human immunodeficiency virus; PID = pelvic inflammatory disease

Cu-IUDs for emergency contraception do not protect against STI/HIV. If risk exists for STI/HIV (including during pregnancy or postpartum), the correct and consistent use of condoms is recommended, either alone or with another contraceptive method. Consistent and correct use of the male latex condom reduces the risk for STIs and HIV transmission.



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