Copper IUD and emergency contraception

Abstract

The article by Turok et al. [1] points out important issues in emergency contraception (EC). We would like to thank the authors for their valuable research. Emergency contraception is used to prevent unintended pregnancy after unprotected intercourse. Currently worldwide, there are two main options for EC, high-dose levonorgestrel and copper IUD. It is clearly stated by Turok et al. [1] that cost was an issue for women when deciding for an IUD insertion. Also, while IUD use is very effective in EC, it is often less preferred and sometimes even not offered to women since it is an invasive procedure compared to the levonorgestrel regimen. However, this should not be the case. In countries where family planning and planned parenthood services are less expensive or funded by the government, like Turkey, copper IUD use is much cheaper and more readily available. The cost of the copper IUD device in Turkey is around US$15 to US$20 depending on the brand, but it is free at maternal health centers and family planning clinics of the government hospitals. In such countries, IUD use should always be considered as an option and offered to women. A major drawback of copper IUD use is the chance of increased incidence of pelvic inflammatory disease (PID). The incidence rate of PID among copper IUD users has been reported to be between 1/100 and 1/1000. As the number of sexual partners increase, this issue gains more importance [2]. When deciding on EC method selection for women, a pregnancy wish in the future should also be determined. The copper IUD should be carefully considered if the woman has multiple partners but also plans to conceive in the future. The study of Turok et al. [1] reminds the health providers of the importance and availability of copper IUD use for EC.