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Objectives
To compare long-acting reversible contraceptive (LARC) method initiation by device
at time of emergency contraception (EC) request.
Methods
All clients who presented to four Planned Parenthood Association of Utah clinics for
EC from February 2021 to April 2022 received printed information about three LARC
options for EC in addition to oral options. LARC options included the copper T380A
intrauterine device (IUD), 52 mg levonorgestrel (LNG) IUD, and the guideline-supported
option for oral LNG with same-day etonogestrel (ENG) implant. Participants were aged
18–35, who reported unprotected intercourse within five days with negative pregnancy
testing. We assessed demographic variables associated with method selection and reasons
for method choice. LARC methods were available at no cost.
Results
A total of 194 EC clients (18% of 1,086 approached) requested LARC and 187 qualified:
24% (n=44) selected a copper IUD, 23% (n=43) a 52 mg LNG IUD, and 54% (n=100) an ENG
implant and oral LNG. ENG implant users were younger (22.9) than those selecting the
LNG IUD (25.4) or copper IUD (25.9, p<0.01). Copper IUD users had a lower mean BMI
(24.0) than those selecting an LNG IUD (27.0) or ENG implant and oral LNG (27.1, p=0.01).
Commonly cited reasons for choosing ENG implant and oral LNG included having friends
using the same method (30.0%), wanting fewer side effects (20.0%), and wanting lighter
or no bleeding (18.0%).
Conclusions
In this observational study of EC clients desiring LARC, participants more frequently
selected the ENG implant with oral LNG over either IUD, despite a lack of EC efficacy
data for the ENG implant with oral LNG.
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Copyright
© 2022 Published by Elsevier Inc.
