Hormonal Contraception, Copper IUD Use Associated With Lower Risk for Ectopic Pregnancy – Clinical Advisor
The initial results of the CHOICE Project were first published in 2010; the study authors aimed to “introduce and promote the use of long-acting reversible methods of contraception [LARCS].”2 To build on this research, Paige Schultheis, BA, a medical student at the Indiana University School of Medicine, and colleagues calculated the number of ectopic pregnancies that occurred during use of various contraceptive methods. This information was collected in follow-up telephone surveys of CHOICE participants.
The rate of ectopic pregnancy per 1000 person-years was 6.9 in the no contraceptive/condom group compared with 0.5 in the LNG-IUD group; 0.46 in the copper IUD group; and 0.22 in the contraceptive patch group, OC, or vaginal ring subgroups. No ectopic pregnancies were reported among participants choosing implant or depot medroxyprogesterone acetate (DMPA) methods.
Participants who used an LNG-IUD (hazard ratio [HR], 0.06), copper IUD (HR, 0.08), OC, contraceptive patch, or vaginal ring (HR, 0.04) had a reduced risk of ectopic pregnancy compared with participants who used no contraceptive methods or condoms.
The study authors pointed out that 75% of the cohort was using highly effective contraceptive methods; therefore, the total number of ectopic pregnancies available for analysis across each contraceptive method was inherently limited.
They noted, however, that CHOICE is one of the largest prospective cohort studies (N=9256) to analyze the effect of varied contraceptive methods on ectopic pregnancy rates. “Our study covers a wider range of contraceptive methods than previous studies, and the forms of contraception included in our study are more contemporary than currently included in previous literature,” the researchers said.
Disclosure: 2 authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
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