A 20-year-old woman requests emergency contraception 72 hours after unprotected intercourse. Which method provides the highest efficacy at this time point?
- A Levonorgestrel 1.5 mg orally (Plan B)
- B Copper IUD insertion ✓
- C Ulipristal acetate 30 mg orally (ella)
- D Combined oestrogen-progestogen (Yuzpe method)
Correct answer: B. Copper IUD insertion
Explanation
Copper IUD insertion within 5 days of unprotected intercourse provides the highest efficacy (> 99%) regardless of when in the 5-day window it is inserted, making it the most effective emergency contraceptive. Ulipristal acetate maintains consistent efficacy throughout 120 hours and is superior to levonorgestrel particularly after 72 hours. Levonorgestrel efficacy diminishes significantly by 72 hours. The Yuzpe method is the least effective of these options.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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Written and medically reviewed by the StethoPrep medical team.