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Copper IUD emergency contraception — DFSRH MCQ

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EasyEmergency contraceptionCopper IUD emergency contraceptionDFSRH

A 24-year-old woman attends 96 hours after unprotected vaginal sex on day 14 of a regular 28-day cycle. She wants the most effective emergency contraception and would accept ongoing contraception if suitable. Pregnancy test is negative. What is the most appropriate management?

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Correct answer: A — Offer same-day copper IUD insertion for emergency contraception

The copper IUD is the most effective EC and can be inserted within 5 days of first UPSI or within 5 days of the earliest likely ovulation. Ulipristal is effective oral EC, but immediate progestogen can reduce its effect and it is less effective than a Cu-IUD. LNG is less effective this late in the window, the LNG-IUD is not recommended as EC, and a negative test at 96 hours cannot exclude conception from that episode. The pearl is to offer Cu-IUD whenever appropriate, even if oral EC is also discussed.

Reference: FSRH Guideline: Emergency Contraception