Original research article| Volume 94, ISSUE 1, P48-51, July 2016

EC4U: results from a pilot project integrating the copper IUC into emergency contraceptive care



      The copper intrauterine contraceptive (IUC) is the most effective method of emergency contraception (EC), yet it is underutilized. The objective was to evaluate a pilot project integrating the copper IUC into EC care.

      Study Design

      Single-group evaluation study. Nine geographically diverse reproductive health centers implemented 6-month pilot interventions. All interventions included staff education and inclusion of the IUC in EC patient counseling; some sites developed patient education materials. Health center staff completed manual monthly tracking forms of the number of EC patients receiving oral levonorgestrel, ulipristal acetate or the copper IUC. Sites also tracked and reported the number of patients returning for removal during the 6-month pilot period and for 5 subsequent months. Main study outcomes included the number of IUC for EC insertions, the proportion that were same-day insertions and the proportion of patients receiving each EC type during the pilot period. A secondary outcome was the number of patients who had returned for removal at 5 months postpilot.


      There were 101 IUC insertions for EC during the pilot period. Seventy-seven percent were same-day insertions; the remainder returned for insertion within 5 days of unprotected intercourse. The percentage of EC patients choosing the IUC varied by site from 1 to 16% (overall=7%). At 5 months postpilot, 20 patients (20%) had returned for removal.


      Some women will be interested in the copper IUC for EC, and therefore, all women should be offered this option. Results suggest that the large majority continued to use the IUC for ongoing contraception.


      Copper IUCs are a viable option for women in need of EC. All women should be offered the most effective EC option.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Contraception
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Cleland K.
        • Zhu H.
        • Goldstuck N.
        • Cheng L.
        • Trussell J.
        The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience.
        Hum Reprod. 2012; 27: 1994-2000
        • Cheng L.
        • Gulmezoglu A.M.
        • Piaggio G.
        • Ezcurra E.
        • PF Van Look
        Interventions for emergency contraception.
        Cochrane Database Syst Rev. 2008; CD001324
        • McKay R.
        • Gilbert L.
        Use of IUDs for emergency contraception: current perspectives.
        Open Access J Contracept. 2014; 5: 53-63
        • Belden P.
        • Harper C.C.
        • Speidel J.J.
        The copper IUD for emergency contraception, a neglected option.
        Contraception. 2012; 85: 338-339
        • Harper C.C.
        • Blum M.
        • de Bocanegra H.T.
        • Darney P.D.
        • Spiedel J.J.
        • Policar M.
        • et al.
        Challenges in translating evidence to practice: the provision of intrauterine contraception.
        Obstet Gynecol. 2008; 111: 1359-1369
        • Turok D.K.
        • Gurtcheff S.E.
        • Handley E.
        • Simonsen S.E.
        • Sok C.
        • North R.
        • et al.
        A survey of women obtaining emergency contraception: are they interested in using the copper IUD?.
        Contraception. 2011; 83: 441-446
        • Schwarz E.B.
        • Kavanaugh M.
        • Douglas E.
        • Dubowitz T.
        • Creinin M.D.
        Interest in intrauterine contraception among seekers of emergency contraception and pregnancy testing.
        Obstet Gynecol. 2009; 113: 833-839
        • Schwarz E.B.
        • Papic M.
        • Parisi S.
        • Baldauf E.
        • Rapkin R.
        • Updike G.
        Routine counseling about intrauterine contraception for women seeking emergency contraception.
        Contraception. 2014; 90: 66-71
        • Harper C.C.
        • Speidel J.J.
        • Drey E.A.
        • Trussell J.
        • Blum M.
        • Darney P.D.
        Copper intrauterine device for emergency contraception.
        Obstet Gynecol. 2012; 119: 220-226
        • Kapp N.
        • Abitbol J.L.
        • Mathe H.
        • Scherrer B.
        • Guillard H.
        • Gainer E.
        • et al.
        Effect of body weight and BMI on the efficacy of levonorgestrel emergency contraception.
        Contraception. 2015; 91: 97-104
        • Glasier A.
        • Cameron S.T.
        • Blithe D.
        • Scherrer B.
        • Mathe H.
        • Levy D.
        • et al.
        Can we identify women at risk of pregnancy despite using emergency contraception? data from randomized trials of ulipristal acetate and levonorgestrel.
        Contraception. 2011; 84: 363-367
        • Moreau C.
        • Trussell J.
        Results from pooled phase III studies of ulipristal acetate for emergency contraception.
        Contraception. 2012; 86: 673-680
        • Turok D.K.
        • Jacobson J.C.
        • Dermish A.I.
        • Simonsen S.E.
        • Gurtcheff S.
        • McFadden M.
        • et al.
        Emergency contraception with a copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates.
        Contraception. 2014; 89: 222-228
        • Turok D.K.
        • Gurtcheff S.E.
        • Handley E.
        • Simonsen S.E.
        • Sok C.
        • Murphy P.
        A pilot study of the copper T380A IUD and oral levonorgestrel for emergency contraception.
        Contraception. 2010; 82: 520-525
        • Peipert J.F.
        • Zhao Q.
        • Allsworth J.E.
        • Petrosky E.
        • Madden T.
        • Eisenberg D.
        • et al.
        Continuation and satisfaction of reversible contraception.
        Obstet Gynecol. 2011; 117: 1105-1113