skip to main content

Antiphospholipid antibodies contraception — DFSRH MCQ

Instant feedback + full explanation. One question, done properly.

HardUKMECAntiphospholipid antibodies contraceptionDFSRH

A 38-year-old with systemic lupus erythematosus and persistent antiphospholipid antibodies wants long-acting reversible contraception. She has heavy periods, normal renal function and no previous thrombosis. Which method should be discussed first?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — A 52 mg LNG-IUD after confirming routine insertion eligibility

The best answer is “A 52 mg LNG-IUD after confirming routine insertion eligibility”. Persistent antiphospholipid antibodies make CHC unsuitable and require care with systemic progestogen methods. A 52 mg LNG-IUD is medically eligible, highly effective and likely to reduce her heavy bleeding, so it best combines safety and symptom priorities. A copper IUD has no hormonal thrombosis concern but may aggravate bleeding. The implant and DMPA have less favourable eligibility or bleeding trade-offs in this setting.

Reference: CoSRH, UK Medical Eligibility Criteria for Contraceptive Use 2025: https://www.cosrh.org/Common/Uploaded%20files/documents/UKMEC_2025.pdf | CoSRH/FSRH, Intrauterine Contraception (March 2023, amended January 2025): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-clinical-guideline-intrauterine-contraception-mar-23-amended.pdf