Download Among current users of intrauterine devices, there is an increased

Among current users of intrauterine devices, there is an increased risk of an
ectopic pregnancy in the unlikely event pregnancy occurs during use though the
absolute numbers are decreased
Conclusion
Since fewer pregnancies occur for users of contraception, the absolute number of ectopic
pregnancies is reduced because there are fewer pregnancies. However, if a pregnancy occurs with
either a copper IUD or a levonorgestrel intrauterine system, it is important to rule out the occurrence
of an ectopic pregnancy, as it appears that the ratio of ectopic pregnancies to intrauterine
pregnancies may be increased.
Clinical Question
Is there an increased risk of ectopic pregnancy among women using an IUD?
Search Terms
Intrauterine device, IUD, levonorgestrel intrauterine system, ectopic pregnancy
Citation
Furlong L. Ectopic pregnancy risk when contraception fails. J Reprod Med 2002;47:881-885.
Object of Research
Intrauterine devices
Research Outcome
Ectopic pregnancy rate
Study Features
This is a review of data submissions by pharmaceutical companies to the US Food and Drug
Administration in support of the applications for approval of their contraceptives. Data were
obtained from clinical trials conducted by the companies. The US population rate for ectopic
pregnancy was obtained from the Center for Disease Control.
Evidence Grade: Level 2
The Evidence
For the Copper T IUD, the ratio of ectopic pregnancies to total pregnancies was 1:16 compared to
1:50, the estimate for all pregnancies in the United States. In a large post-marketing study in
Finland, 18 ectopic pregnancies out of 232 pregnancies were identified though the copper device
brands were not provided. This ratio is 1:13 similar to that found in the original FDA submission.
For the levonorgestrel IUD, the ratio of ectopic pregnancies to total pregnancies is 1:2, but this ratio
is based on only 10 pregnancies from their clinical trial studies. Still, from the large Finnish
postmarketing study, 44 out of 108 pregnancies yielding a ratio of 1:2.3 consistent with the data
submitted to the US Food and Drug Administration.
Appraised by: The Jordan EBM Reproductive Health Group
Update by: 22 March 2016