A 31-year-old woman presents 5 days after a single episode of unprotected intercourse, requesting emergency contraception. She also wants highly effective reversible contraception for the next few years. She has no contraindications to any method. Which is the MOST appropriate option?
- A Copper IUD insertion now, kept in place for ongoing contraception ✓
- B Ulipristal acetate 30 mg single oral dose now
- C Levonorgestrel 1.5 mg single oral dose now
- D Yuzpe regimen of combined pills repeated in 12 hours
Correct answer: A. Copper IUD insertion now, kept in place for ongoing contraception
Explanation
The copper IUD is the most effective emergency contraceptive when inserted within 5 days of intercourse or within 5 days of expected ovulation, with a failure rate below 0.1%, and it provides excellent ongoing contraception, matching this patient's wishes. Levonorgestrel and ulipristal are oral options with higher failure rates, roughly 1 to 2%, and ulipristal requires a prescription with a 120-hour window. The Yuzpe regimen is the least effective oral method and causes more nausea.
Reference: Williams Gynecology, 3rd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.