Cu-IUD EC ongoing use — DFSRH MCQ

Correct answer: E — Test if her next period is late or abnormal, or at least 21 days after any later UPSI

The best answer is “Test if her next period is late or abnormal, or at least 21 days after any later UPSI”. A Cu-IUD inserted appropriately for EC can remain for ongoing contraception, pregnancy testing depends on subsequent bleeding or later UPSI risk. Weekly testing is unnecessary, and adding oral EC after successful Cu-IUD placement is not required. Removal after 5 days would lose ongoing contraception, and POP is not needed to make a Cu-IUD effective. The pearl is that the EC device can become the long-term method. Emergency-contraception choice requires the timing of every episode of UPSI, likely ovulation, weight or BMI, recent progestogen exposure, enzyme-inducing medicines, gastrointestinal absorption and the person’s willingness to use a copper IUD. The copper IUD remains the most effective option and is the only method effective after ovulation; oral agents mainly work by delaying ovulation and are not interchangeable in every scenario.

Reference: CoSRH/FSRH, Emergency Contraception (amended July 2023): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-emergency-contraception03dec2020-amendedjuly2023-11jul.pdf