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Extending the Time Limit for Starting the Yuzpe Regimen of Emergency Contraception to 120 Hours

2003; Lippincott Williams & Wilkins; Volume: 101; Issue: 6 Linguagem: Inglês

10.1097/00006250-200306000-00006

1873-233X

Charlotte Ellertson, M.R.B. Evans, Sue Ferden, Clare Leadbetter, Aileen Spears, Karen Johnstone, James Trussell,

Maternal and fetal healthcare

In Brief OBJECTIVE Current protocols state that the Yuzpe regimen of emergency contraception can be initiated up to 72 hours after unprotected intercourse. The purpose of this study was to determine whether the window for emergency hormonal contraception can be extended to 120 hours. METHODS In an observational study, we tracked 111 women who requested emergency contraception between 72 and 120 hours after unprotected sex but refused postcoital copper intrauterine devices (IUDs), preferring instead the Yuzpe regimen. We compared failure rates for this group with rates among 675 otherwise similar women who started the same therapy within 72 hours. RESULTS Both perfect use (1.9%) and typical use (3.6%) failure rates were low among women presenting between 72 and 120 hours after unprotected intercourse. These rates did not statistically differ from failure rates for the standard Yuzpe regimen (2.0% during perfect use and 2.5% during typical use). Our small sample size of 111, however, gave us just 25% power to detect a doubling in the failure rates (2% to 4%) and 59% power to detect a tripling in the failure rates (2% to 6%). CONCLUSION The 72-hour cutoff for the Yuzpe regimen of emergency contraception appears needlessly restrictive. Women who request this therapy more than 72 hours after unprotected sex should be allowed to receive it, particularly if they decline postcoital insertion of a copper IUD and would otherwise have no options for reducing pregnancy risk. Because the Yuzpe regimen of emergency contraception is at least partially effective when started up to 120 hours after unprotected intercourse, current protocols are too restrictive.