Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2017 Aug 2;8(8):CD001324.
doi: 10.1002/14651858.CD001324.pub5.

Interventions for emergency contraception

Jie Shen  1 , Yan Che, Emily Showell, Ke Chen, Linan Cheng
Affiliations
Meta-Analysis

Interventions for emergency contraception

Jie Shen et al. Cochrane Database Syst Rev. .

Update in

  • Interventions for emergency contraception.
    Shen J, Che Y, Showell E, Chen K, Cheng L. Shen J, et al. Cochrane Database Syst Rev. 2019 Jan 20;1(1):CD001324. doi: 10.1002/14651858.CD001324.pub6. Cochrane Database Syst Rev. 2019. PMID: 30661244 Free PMC article.

Abstract

Background: Emergency contraception (EC) is using a drug or copper intrauterine device (Cu-IUD) to prevent pregnancy shortly after unprotected intercourse. Several interventions are available for EC. Information on the comparative effectiveness, safety and convenience of these methods is crucial for reproductive healthcare providers and the women they serve. This is an update of a review previously published in 2009 and 2012.

Objectives: To determine which EC method following unprotected intercourse is the most effective, safe and convenient to prevent pregnancy.

Search methods: In February 2017 we searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, Popline and PubMed, The Chinese biomedical databases and UNDP/UNFPA/WHO/World Bank Special Programme on Human Reproduction (HRP) emergency contraception database. We also searched ICTRP and ClinicalTrials.gov as well as contacting content experts and pharmaceutical companies, and searching reference lists of appropriate papers.

Selection criteria: Randomised controlled trials including women attending services for EC following a single act of unprotected intercourse were eligible.

Data collection and analysis: We used standard methodological procedures recommended by Cochrane. The primary review outcome was observed number of pregnancies. Side effects and changes of menses were secondary outcomes.

Main results: We included 115 trials with 60,479 women in this review. The quality of the evidence for the primary outcome ranged from moderate to high, and for other outcomes ranged from very low to high. The main limitations were risk of bias (associated with poor reporting of methods), imprecision and inconsistency. Comparative effectiveness of different emergency contraceptive pills (ECP)Levonorgestrel was associated with fewer pregnancies than Yuzpe (estradiol-levonorgestrel combination) (RR 0.57, 95% CI 0.39 to 0.84, 6 RCTs, n = 4750, I2 = 23%, high-quality evidence). This suggests that if the chance of pregnancy using Yuzpe is assumed to be 29 women per 1000, the chance of pregnancy using levonorgestrel would be between 11 and 24 women per 1000.Mifepristone (all doses) was associated with fewer pregnancies than Yuzpe (RR 0.14, 95% CI 0.05 to 0.41, 3 RCTs, n = 2144, I2 = 0%, high-quality evidence). This suggests that if the chance of pregnancy following Yuzpe is assumed to be 25 women per 1000 women, the chance following mifepristone would be between 1 and 10 women per 1000.Both low-dose mifepristone (less than 25 mg) and mid-dose mifepristone (25 mg to 50 mg) were probably associated with fewer pregnancies than levonorgestrel (RR 0.72, 95% CI 0.52 to 0.99, 14 RCTs, n = 8752, I2 = 0%, high-quality evidence; RR 0.61, 95% CI 0.45 to 0.83, 27 RCTs, n = 6052, I2 = 0%, moderate-quality evidence; respectively). This suggests that if the chance of pregnancy following levonorgestrel is assumed to be 20 women per 1000, the chance of pregnancy following low-dose mifepristone would be between 10 and 20 women per 1000; and that if the chance of pregnancy following levonorgestrel is assumed to be 35 women per 1000, the chance of pregnancy following mid-dose mifepristone would be between 16 and 29 women per 1000.Ulipristal acetate (UPA) was associated with fewer pregnancies than levonorgestrel (RR 0.59; 95% CI 0.35 to 0.99, 2 RCTs, n = 3448, I2 = 0%, high-quality evidence). Comparative effectiveness of different ECP dosesIt was unclear whether there was any difference in pregnancy rate between single-dose levonorgestrel (1.5 mg) and the standard two-dose regimen (0.75 mg 12 hours apart) (RR 0.84, 95% CI 0.53 to 1.33, 3 RCTs, n = 6653, I2 = 0%, moderate-quality evidence).Mid-dose mifepristone was associated with fewer pregnancies than low-dose mifepristone (RR 0.73; 95% CI 0.55 to 0.97, 25 RCTs, n = 11,914, I2 = 0%, high-quality evidence). Comparative effectiveness of Cu-IUD versus mifepristoneThere was no conclusive evidence of a difference in the risk of pregnancy between the Cu-IUD and mifepristone (RR 0.33, 95% CI 0.04 to 2.74, 2 RCTs, n = 395, low-quality evidence). Adverse effectsNausea and vomiting were the main adverse effects associated with emergency contraception. There is probably a lower risk of nausea (RR 0.63, 95% CI 0.53 to 0.76, 3 RCTs, n = 2186 , I2 = 59%, moderate-quality evidence) or vomiting (RR 0.12, 95% CI 0.07 to 0.20, 3 RCTs, n = 2186, I2 = 0%, high-quality evidence) associated with mifepristone than with Yuzpe. levonorgestrel is probably associated with a lower risk of nausea (RR 0.40, 95% CI 0.36 to 0.44, 6 RCTs, n = 4750, I2 = 82%, moderate-quality evidence), or vomiting (RR 0.29, 95% CI 0.24 to 0.35, 5 RCTs, n = 3640, I2 = 78%, moderate-quality evidence) than Yuzpe. Levonorgestrel users were less likely to have any side effects than Yuzpe users (RR 0.80, 95% CI 0.75 to 0.86; 1 RCT, n = 1955, high-quality evidence). UPA users were more likely than levonorgestrel users to have resumption of menstruation after the expected date (RR 1.65, 95% CI 1.42 to 1.92, 2 RCTs, n = 3593, I2 = 0%, high-quality evidence). Menstrual delay was more common with mifepristone than with any other intervention and appeared to be dose-related. Cu-IUD may be associated with higher risks of abdominal pain than mifepristone (18 events in 95 women using Cu-IUD versus no events in 190 women using mifepristone, low-quality evidence).

Authors' conclusions: Levonorgestrel and mid-dose mifepristone (25 mg to 50 mg) were more effective than Yuzpe regimen. Both mid-dose (25 mg to 50 mg) and low-dose mifepristone(less than 25 mg) were probably more effective than levonorgestrel (1.5 mg). Mifepristone low dose (less than 25 mg) was less effective than mid-dose mifepristone. UPA was more effective than levonorgestrel.Levonorgestrel users had fewer side effects than Yuzpe users, and appeared to be more likely to have a menstrual return before the expected date. UPA users were probably more likely to have a menstrual return after the expected date. Menstrual delay was probably the main adverse effect of mifepristone and seemed to be dose-related. Cu-IUD may be associated with higher risks of abdominal pain than ECPs.

PubMed Disclaimer

Conflict of interest statement

JS: no conflicts of interest. YC: no conflicts of interest KC: no conflicts of interest LC: participated in emergency contraceptive trials included in this review (including Chen 2011). LC did not participate in selecting these studies, or extracting their data. LC has received travel costs and consulting fees from Regenex Pharmaceutical Corporation, China Resources Zizhu Pharmaceutical Co, and Bayer Pharma AG. ES: no conflicts of interest

Figures

Figure 1
Figure 1
Study flow diagram
Figure 2
Figure 2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
Figure 3
Figure 3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
Figure 4
Figure 4
Forest plot of comparison 2.1: levonorgestrel versus Yuzpe, outcome 2.1.1 Observed number of pregnancies (all women)
Figure 5
Figure 5
Funnel plot of comparison 2.4: Low‐dose mifepristone (< 25 mg) versus levonorgestrel 1.5 mg, outcome 2.4.1 Observed number of pregnancies (all women)
Figure 6
Figure 6
Forest plot of comparison 2.4: Low‐dose mifepristone (< 25 mg) versus levonorgestrel 1.5 mg, outcome 2.4.1 ITT (all loss follow‐up as pregnancy in levonorgestrel, and no pregnancy in mifepristone)
Analysis 1.1
Analysis 1.1
Comparison 1 Intrauterine contraceptive device versus control (expectant management), Outcome 1 Observed number of pregnancies.
Analysis 2.1
Analysis 2.1
Comparison 2 Levonorgestrel versus Yuzpe, Outcome 1 Observed number of pregnancies (all women).
Analysis 2.2
Analysis 2.2
Comparison 2 Levonorgestrel versus Yuzpe, Outcome 2 Observed number of pregnancies (by risk status).
Analysis 2.3
Analysis 2.3
Comparison 2 Levonorgestrel versus Yuzpe, Outcome 3 Observed number of pregnancies (time from intercourse).
Analysis 2.4
Analysis 2.4
Comparison 2 Levonorgestrel versus Yuzpe, Outcome 4 Need for extra dose.
Analysis 2.5
Analysis 2.5
Comparison 2 Levonorgestrel versus Yuzpe, Outcome 5 Any side effect.
Analysis 2.6
Analysis 2.6
Comparison 2 Levonorgestrel versus Yuzpe, Outcome 6 Specific side effects.
Analysis 2.7
Analysis 2.7
Comparison 2 Levonorgestrel versus Yuzpe, Outcome 7 Menses.
Analysis 3.1
Analysis 3.1
Comparison 3 Levonorgestrel (all doses) versus anordrin (all doses), Outcome 1 Observed number of pregnancies (all women).
Analysis 3.2
Analysis 3.2
Comparison 3 Levonorgestrel (all doses) versus anordrin (all doses), Outcome 2 Any side effect.
Analysis 4.1
Analysis 4.1
Comparison 4 Mifepristone mid‐dose (25 mg‐50 mg) versus levonorgestrel 1.5 mg, Outcome 1 Observed number of pregnancies (all women).
Analysis 4.2
Analysis 4.2
Comparison 4 Mifepristone mid‐dose (25 mg‐50 mg) versus levonorgestrel 1.5 mg, Outcome 2 Observed number of pregnancies (by risk status).
Analysis 4.3
Analysis 4.3
Comparison 4 Mifepristone mid‐dose (25 mg‐50 mg) versus levonorgestrel 1.5 mg, Outcome 3 Any side effect.
Analysis 4.4
Analysis 4.4
Comparison 4 Mifepristone mid‐dose (25 mg‐50 mg) versus levonorgestrel 1.5 mg, Outcome 4 Specific side effect.
Analysis 4.5
Analysis 4.5
Comparison 4 Mifepristone mid‐dose (25 mg‐50 mg) versus levonorgestrel 1.5 mg, Outcome 5 Menses.
Analysis 4.6
Analysis 4.6
Comparison 4 Mifepristone mid‐dose (25 mg‐50 mg) versus levonorgestrel 1.5 mg, Outcome 6 ITT (all loss follow‐up as pregnancy in LNG, and no preg in Mife).
Analysis 4.7
Analysis 4.7
Comparison 4 Mifepristone mid‐dose (25 mg‐50 mg) versus levonorgestrel 1.5 mg, Outcome 7 ITT (all loss follow‐up as no pregnancy in LNG, and preg in Mife).
Analysis 5.1
Analysis 5.1
Comparison 5 Mifepristone low dose (< 25 mg) versus levonorgestrel 1.5 mg, Outcome 1 Observed number of pregnancies (all women).
Analysis 5.2
Analysis 5.2
Comparison 5 Mifepristone low dose (< 25 mg) versus levonorgestrel 1.5 mg, Outcome 2 Observed number of pregnancies (by risk status).
Analysis 5.3
Analysis 5.3
Comparison 5 Mifepristone low dose (< 25 mg) versus levonorgestrel 1.5 mg, Outcome 3 Observed number of pregnancies (time from intercourse).
Analysis 5.4
Analysis 5.4
Comparison 5 Mifepristone low dose (< 25 mg) versus levonorgestrel 1.5 mg, Outcome 4 Any side effect.
Analysis 5.5
Analysis 5.5
Comparison 5 Mifepristone low dose (< 25 mg) versus levonorgestrel 1.5 mg, Outcome 5 Specific side effect.
Analysis 5.6
Analysis 5.6
Comparison 5 Mifepristone low dose (< 25 mg) versus levonorgestrel 1.5 mg, Outcome 6 Menses.
Analysis 5.7
Analysis 5.7
Comparison 5 Mifepristone low dose (< 25 mg) versus levonorgestrel 1.5 mg, Outcome 7 ITT (all loss follow‐up as pregnancy in LNG, and no preg in Mifepristone).
Analysis 5.8
Analysis 5.8
Comparison 5 Mifepristone low dose (< 25 mg) versus levonorgestrel 1.5 mg, Outcome 8 ITT (all loss follow‐up as no pregnancy in LNG, and preg in Mifepristone).
Analysis 6.1
Analysis 6.1
Comparison 6 Mifepristone (all doses) versus Yuzpe, Outcome 1 Observed number of pregnancies (all women).
Analysis 6.2
Analysis 6.2
Comparison 6 Mifepristone (all doses) versus Yuzpe, Outcome 2 Observed number of pregnancies (by risk status).
Analysis 6.3
Analysis 6.3
Comparison 6 Mifepristone (all doses) versus Yuzpe, Outcome 3 Observed number of pregnancies (time from intercourse).
Analysis 6.4
Analysis 6.4
Comparison 6 Mifepristone (all doses) versus Yuzpe, Outcome 4 Need for extra dose.
Analysis 6.5
Analysis 6.5
Comparison 6 Mifepristone (all doses) versus Yuzpe, Outcome 5 Any side effect.
Analysis 6.6
Analysis 6.6
Comparison 6 Mifepristone (all doses) versus Yuzpe, Outcome 6 Specific side effects.
Analysis 6.7
Analysis 6.7
Comparison 6 Mifepristone (all doses) versus Yuzpe, Outcome 7 Menses.
Analysis 7.1
Analysis 7.1
Comparison 7 Mifepristone (all doses) versus anordrin (all doses), Outcome 1 Observed number of pregnancies (all women).
Analysis 7.2
Analysis 7.2
Comparison 7 Mifepristone (all doses) versus anordrin (all doses), Outcome 2 Any side effect.
Analysis 7.3
Analysis 7.3
Comparison 7 Mifepristone (all doses) versus anordrin (all doses), Outcome 3 Specific side effects.
Analysis 7.4
Analysis 7.4
Comparison 7 Mifepristone (all doses) versus anordrin (all doses), Outcome 4 Menses.
Analysis 8.1
Analysis 8.1
Comparison 8 Mifepristone alone (low or mid dose) versus mifepristone + anordrin (all doses), Outcome 1 Observed number of pregnancies (all women).
Analysis 8.2
Analysis 8.2
Comparison 8 Mifepristone alone (low or mid dose) versus mifepristone + anordrin (all doses), Outcome 2 Any side effect.
Analysis 8.3
Analysis 8.3
Comparison 8 Mifepristone alone (low or mid dose) versus mifepristone + anordrin (all doses), Outcome 3 Specific side effects.
Analysis 8.4
Analysis 8.4
Comparison 8 Mifepristone alone (low or mid dose) versus mifepristone + anordrin (all doses), Outcome 4 Delay in menses.
Analysis 9.1
Analysis 9.1
Comparison 9 Mifepristone versus mifepristone + misoprostol (all doses), Outcome 1 Observed number of pregnancies (all women).
Analysis 9.2
Analysis 9.2
Comparison 9 Mifepristone versus mifepristone + misoprostol (all doses), Outcome 2 Specific side effect.
Analysis 10.1
Analysis 10.1
Comparison 10 Mifepristone alone (all doses) versus mifepristone + tamoxifen (all doses), Outcome 1 Observed number of pregnancies (all women).
Analysis 10.2
Analysis 10.2
Comparison 10 Mifepristone alone (all doses) versus mifepristone + tamoxifen (all doses), Outcome 2 Specific side effect.
Analysis 10.3
Analysis 10.3
Comparison 10 Mifepristone alone (all doses) versus mifepristone + tamoxifen (all doses), Outcome 3 Menses.
Analysis 11.1
Analysis 11.1
Comparison 11 Mifepristone alone (all doses) versus mifepristone + methotrexate (all doses), Outcome 1 Observed number of pregnancy (all women).
Analysis 11.2
Analysis 11.2
Comparison 11 Mifepristone alone (all doses) versus mifepristone + methotrexate (all doses), Outcome 2 Any side effect.
Analysis 11.3
Analysis 11.3
Comparison 11 Mifepristone alone (all doses) versus mifepristone + methotrexate (all doses), Outcome 3 Menses.
Analysis 12.1
Analysis 12.1
Comparison 12 Mifepristone (all doses) versus danazol (all doses), Outcome 1 Observed number of pregnancies (all women).
Analysis 12.2
Analysis 12.2
Comparison 12 Mifepristone (all doses) versus danazol (all doses), Outcome 2 Any side effect.
Analysis 12.3
Analysis 12.3
Comparison 12 Mifepristone (all doses) versus danazol (all doses), Outcome 3 Specific side effect.
Analysis 12.4
Analysis 12.4
Comparison 12 Mifepristone (all doses) versus danazol (all doses), Outcome 4 Menses.
Analysis 13.1
Analysis 13.1
Comparison 13 Mifepristone versus gestrinone, Outcome 1 Observed number of pregnancies (all women).
Analysis 13.2
Analysis 13.2
Comparison 13 Mifepristone versus gestrinone, Outcome 2 Side effects.
Analysis 13.3
Analysis 13.3
Comparison 13 Mifepristone versus gestrinone, Outcome 3 Menses.
Analysis 14.1
Analysis 14.1
Comparison 14 High‐dose oestrogens versus Yuzpe, Outcome 1 Observed number of pregnancies (all women).
Analysis 15.1
Analysis 15.1
Comparison 15 Danazol (all doses) versus Yuzpe, Outcome 1 Observed number of pregnancies (all women).
Analysis 15.2
Analysis 15.2
Comparison 15 Danazol (all doses) versus Yuzpe, Outcome 2 Specific side effects.
Analysis 15.3
Analysis 15.3
Comparison 15 Danazol (all doses) versus Yuzpe, Outcome 3 Menses.
Analysis 16.1
Analysis 16.1
Comparison 16 Ulipristal acetate (all doses) versus levonorgestrel, Outcome 1 Observed number of pregnancies (all women).
Analysis 16.2
Analysis 16.2
Comparison 16 Ulipristal acetate (all doses) versus levonorgestrel, Outcome 2 Observed number of pregnancies (by risk status).
Analysis 16.3
Analysis 16.3
Comparison 16 Ulipristal acetate (all doses) versus levonorgestrel, Outcome 3 Observed number of pregnancies (time from intercourse).
Analysis 16.4
Analysis 16.4
Comparison 16 Ulipristal acetate (all doses) versus levonorgestrel, Outcome 4 Observed number of pregnancies within 0‐72 h.
Analysis 16.5
Analysis 16.5
Comparison 16 Ulipristal acetate (all doses) versus levonorgestrel, Outcome 5 Specific side effects.
Analysis 16.6
Analysis 16.6
Comparison 16 Ulipristal acetate (all doses) versus levonorgestrel, Outcome 6 Menses.
Analysis 17.1
Analysis 17.1
Comparison 17 Levonorgestrel split dose, 24 hours versus 12 hours, Outcome 1 Observed number of pregnancy (all women).
Analysis 17.2
Analysis 17.2
Comparison 17 Levonorgestrel split dose, 24 hours versus 12 hours, Outcome 2 Observed number of pregnancies (by risk status).
Analysis 17.3
Analysis 17.3
Comparison 17 Levonorgestrel split dose, 24 hours versus 12 hours, Outcome 3 Specific side effects.
Analysis 17.4
Analysis 17.4
Comparison 17 Levonorgestrel split dose, 24 hours versus 12 hours, Outcome 4 Menses.
Analysis 18.1
Analysis 18.1
Comparison 18 Levonorgestrel single dose versus split dose, Outcome 1 Observed number of pregnancies (all women).
Analysis 18.2
Analysis 18.2
Comparison 18 Levonorgestrel single dose versus split dose, Outcome 2 Observed number of pregnancies (by risk status).
Analysis 18.3
Analysis 18.3
Comparison 18 Levonorgestrel single dose versus split dose, Outcome 3 Observed number of pregnancies (time from intercourse).
Analysis 18.4
Analysis 18.4
Comparison 18 Levonorgestrel single dose versus split dose, Outcome 4 Specific side effects.
Analysis 18.5
Analysis 18.5
Comparison 18 Levonorgestrel single dose versus split dose, Outcome 5 Menses.
Analysis 19.1
Analysis 19.1
Comparison 19 Mifepristone low dose (10 mg) versus low dose (5 mg), Outcome 1 Observed number of pregnancies (all women).
Analysis 19.2
Analysis 19.2
Comparison 19 Mifepristone low dose (10 mg) versus low dose (5 mg), Outcome 2 Specific side effects.
Analysis 19.3
Analysis 19.3
Comparison 19 Mifepristone low dose (10 mg) versus low dose (5 mg), Outcome 3 Delay of menses.
Analysis 20.1
Analysis 20.1
Comparison 20 Low dose mifepristone (10 mg) versus split low dose mifepristone (10 mg x2), Outcome 1 Observed number of pregnancies (all women).
Analysis 20.2
Analysis 20.2
Comparison 20 Low dose mifepristone (10 mg) versus split low dose mifepristone (10 mg x2), Outcome 2 Any side effect.
Analysis 20.3
Analysis 20.3
Comparison 20 Low dose mifepristone (10 mg) versus split low dose mifepristone (10 mg x2), Outcome 3 Menses.
Analysis 21.1
Analysis 21.1
Comparison 21 Mifepristone mid dose (25‐50 mg) versus mifepristone low dose (< 25 mg), Outcome 1 Observed number of pregnancies (all women).
Analysis 21.2
Analysis 21.2
Comparison 21 Mifepristone mid dose (25‐50 mg) versus mifepristone low dose (< 25 mg), Outcome 2 Observed number of pregnancies (by risk status).
Analysis 21.3
Analysis 21.3
Comparison 21 Mifepristone mid dose (25‐50 mg) versus mifepristone low dose (< 25 mg), Outcome 3 Any side effect.
Analysis 21.4
Analysis 21.4
Comparison 21 Mifepristone mid dose (25‐50 mg) versus mifepristone low dose (< 25 mg), Outcome 4 Specific side effects.
Analysis 21.5
Analysis 21.5
Comparison 21 Mifepristone mid dose (25‐50 mg) versus mifepristone low dose (< 25 mg), Outcome 5 Menses.
Analysis 22.1
Analysis 22.1
Comparison 22 Mifepristone mid dose (50 mg) versus mifepristone mid dose (25 mg), Outcome 1 Observed number of pregnancies (all women).
Analysis 22.2
Analysis 22.2
Comparison 22 Mifepristone mid dose (50 mg) versus mifepristone mid dose (25 mg), Outcome 2 Any side effect.
Analysis 22.3
Analysis 22.3
Comparison 22 Mifepristone mid dose (50 mg) versus mifepristone mid dose (25 mg), Outcome 3 Specific side effects.
Analysis 22.4
Analysis 22.4
Comparison 22 Mifepristone mid dose (50 mg) versus mifepristone mid dose (25 mg), Outcome 4 Delay in menses.
Analysis 23.1
Analysis 23.1
Comparison 23 Mid dose mifepristone split dose comparisons, Outcome 1 Observed number of pregnancies (all women).
Analysis 23.2
Analysis 23.2
Comparison 23 Mid dose mifepristone split dose comparisons, Outcome 2 Any side effect.
Analysis 23.3
Analysis 23.3
Comparison 23 Mid dose mifepristone split dose comparisons, Outcome 3 Early menses.
Analysis 23.4
Analysis 23.4
Comparison 23 Mid dose mifepristone split dose comparisons, Outcome 4 Delay menses.
Analysis 24.1
Analysis 24.1
Comparison 24 Mifepristone high dose (> 50 mg) versus mifepristone low dose (< 25 mg), Outcome 1 Observed number of pregnancies (all women).
Analysis 24.2
Analysis 24.2
Comparison 24 Mifepristone high dose (> 50 mg) versus mifepristone low dose (< 25 mg), Outcome 2 Observed number of pregnancies (by risk status).
Analysis 24.3
Analysis 24.3
Comparison 24 Mifepristone high dose (> 50 mg) versus mifepristone low dose (< 25 mg), Outcome 3 Any side effect.
Analysis 24.4
Analysis 24.4
Comparison 24 Mifepristone high dose (> 50 mg) versus mifepristone low dose (< 25 mg), Outcome 4 Specific side effects.
Analysis 24.5
Analysis 24.5
Comparison 24 Mifepristone high dose (> 50 mg) versus mifepristone low dose (< 25 mg), Outcome 5 Menses.
Analysis 25.1
Analysis 25.1
Comparison 25 Mifepristone high dose (> 50 mg) versus mifepristone mid dose (25‐50 mg), Outcome 1 Observed number of pregnancies (all women).
Analysis 25.2
Analysis 25.2
Comparison 25 Mifepristone high dose (> 50 mg) versus mifepristone mid dose (25‐50 mg), Outcome 2 Any side effect.
Analysis 25.3
Analysis 25.3
Comparison 25 Mifepristone high dose (> 50 mg) versus mifepristone mid dose (25‐50 mg), Outcome 3 Specific side effects.
Analysis 25.4
Analysis 25.4
Comparison 25 Mifepristone high dose (> 50 mg) versus mifepristone mid dose (25‐50 mg), Outcome 4 Menses.
Analysis 26.1
Analysis 26.1
Comparison 26 Half‐dose Yuzpe versus standard Yuzpe, Outcome 1 Observed number of pregnancies (all women).
Analysis 26.2
Analysis 26.2
Comparison 26 Half‐dose Yuzpe versus standard Yuzpe, Outcome 2 Any side effect.
Analysis 26.3
Analysis 26.3
Comparison 26 Half‐dose Yuzpe versus standard Yuzpe, Outcome 3 Specific side effects.
Analysis 27.1
Analysis 27.1
Comparison 27 Copper intrauterine device versus mifepristone (all doses), Outcome 1 Observed number of pregnancies (all women).
Analysis 27.2
Analysis 27.2
Comparison 27 Copper intrauterine device versus mifepristone (all doses), Outcome 2 Any side effect.
Analysis 27.3
Analysis 27.3
Comparison 27 Copper intrauterine device versus mifepristone (all doses), Outcome 3 Specific side effects.
Analysis 27.4
Analysis 27.4
Comparison 27 Copper intrauterine device versus mifepristone (all doses), Outcome 4 Menses.
Analysis 28.1
Analysis 28.1
Comparison 28 Time elapsed since intercourse in levonorgestrel, Outcome 1 ≤ 24 h vs > 24‐48 h.
Analysis 28.2
Analysis 28.2
Comparison 28 Time elapsed since intercourse in levonorgestrel, Outcome 2 ≤ 24 h vs > 48‐72 h.
Analysis 28.3
Analysis 28.3
Comparison 28 Time elapsed since intercourse in levonorgestrel, Outcome 3 > 24‐48 h vs > 48‐72 h.
Analysis 28.4
Analysis 28.4
Comparison 28 Time elapsed since intercourse in levonorgestrel, Outcome 4 < 72 h vs > 72 h.
Analysis 29.1
Analysis 29.1
Comparison 29 Time elapsed since intercourse (coitus‐treatment interval) in mifepristone, Outcome 1 ≤ 24 h vs > 24‐48 h.
Analysis 29.2
Analysis 29.2
Comparison 29 Time elapsed since intercourse (coitus‐treatment interval) in mifepristone, Outcome 2 ≤ 24 h vs > 48‐72 h.
Analysis 29.3
Analysis 29.3
Comparison 29 Time elapsed since intercourse (coitus‐treatment interval) in mifepristone, Outcome 3 > 24‐48 h vs > 48‐72 h.
Analysis 29.4
Analysis 29.4
Comparison 29 Time elapsed since intercourse (coitus‐treatment interval) in mifepristone, Outcome 4 < 72 h vs > 72 h.
Analysis 30.1
Analysis 30.1
Comparison 30 Time elapsed since intercourse in Yuzpe, Outcome 1 ≤ 24 h vs > 24‐48 h.
Analysis 30.2
Analysis 30.2
Comparison 30 Time elapsed since intercourse in Yuzpe, Outcome 2 ≤ 24 h vs > 48‐72 h.
Analysis 30.3
Analysis 30.3
Comparison 30 Time elapsed since intercourse in Yuzpe, Outcome 3 > 24‐48 h vs > 48‐72 h.
Analysis 31.1
Analysis 31.1
Comparison 31 Time elapsed since intercourse in ulipristal acetate, Outcome 1 ≤ 24 h vs > 24‐48 h.
Analysis 31.2
Analysis 31.2
Comparison 31 Time elapsed since intercourse in ulipristal acetate, Outcome 2 ≤ 24 h vs > 48‐72 h.
Analysis 31.3
Analysis 31.3
Comparison 31 Time elapsed since intercourse in ulipristal acetate, Outcome 3 > 24‐48 h vs > 48‐72 h.
Analysis 31.4
Analysis 31.4
Comparison 31 Time elapsed since intercourse in ulipristal acetate, Outcome 4 < 72 h vs > 72 h.
Analysis 32.1
Analysis 32.1
Comparison 32 High‐risk women versus low‐risk women (all hormonal methods), Outcome 1 Observed number of pregnancies.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

    1. Arowojolu AO, Okewole LA, Adekunle AO. Comparative evaluation of the effectiveness and safety of two regimens of levonorgestrel for emergency contraception in Nigerians. Contraception 2002;66:269‐73. - PubMed
    1. Ashok PW, Stalder C, Wagaarachchi PT, Flett GM, Melvin L, Templeton A. A randomised study comparing a low dose of mifepristone and the Yuzpe regimen for emergency contraception. BJOG 2002;109:553‐60. - PubMed
    1. Askalani AH, Al‐Senity AM, Al‐Agizy HM, Salam HI, Al‐Masry GI, El‐Sadek SM. Evaluation of copper T‐200 as a post‐coital contraceptive. Egyptian Journal of Obstetrics and Gynaecology 1987;13:63‐6.
    1. Bu GY, Yang MY, Cao XL. Clinical study on administration of low dose of mifepristone and levonorgestrel in urgent postcoital contraception [小剂量米非司酮和左炔诺孕酮用于紧急避孕的临床研究]. Progress in Modern Biomedicine 2006;6(2):53‐4.
    1. Cao P, Li M, Xu J, Li Q. Different doses of mifepristone for emergency contraception [不同剂量米非司酮用于紧急避孕效果的观察与分析]. Journal of Practical Obstetrics and Gynecology 1999;15:295‐6.

References to studies excluded from this review

    1. Ashok PW, Wagaarachchi PT, Flett GM, Templeton A. Mifepristone as a late post‐coital contraceptive. Human Reproduction 2001;16:72‐5. - PubMed
    1. Ashok PW, Hamoda H, Flett GMM, Templeton A. Mifepristone versus the Yuzpe regimen (PC4) for emergency contraception. International Journal of Gynecology and Obstetrics 2004;87:188‐93. - PubMed
    1. Ban X, Xiao Y, Fan H, Liu G, Liu Q, Yu L. A comparative clinical study on Tcu380A and Cu‐IUD for emergency contraception. Maternal & Child Health Care of China 2001;16:498‐501.
    1. Benagiano G, Hertzen H. Towards more effective emergency contraception?. Lancet 2010;375(9714):527‐28. - PubMed
    1. Brache V, Cochon L, Deniaud M, Croxatto HB. Ulipristal acetate prevents ovulation more effectively than levonorgestral: analysis of pooled data from three randomized trials of emergency contraception regimens. Contraception 2013;88(5):611‐8. - PubMed

References to ongoing studies

    1. NCT01539720. Levonorgestrel intrauterine system for emergency contraception (LIFE). clinicaltrials.gov/show/NCT01539720 first received: 21 February, 2012.
    1. NCT02175030. RAPID EC ‐ RCT assessing pregnancy with intrauterine devices for EC. clinicaltrials.gov/show/NCT02175030 first received: 23 June , 2014.
    1. NCT02577601. Impact of combined hormonal contraceptives on UPA. clinicaltrials.gov/show/NCT02577601 first received: 5 August , 2015.

Additional references

    1. Baird DT, Cameron S, Evers JLH, Gemzell‐Danielsson K, Glasier A, Moreau C, et al. Emergency contraception. Widely available and effective but disappointing as a public health intervention: a review. Hum Reprod 2015;30(4):751‐60. - PMC - PubMed
    1. Cleland K, Zhu H, Goldstuck N, Cheng L, Trussell J. The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience.. Hum Reprod 2012;27:1994‐2000. - PMC - PubMed
    1. Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 9: Analysing data and undertaking meta‐analyses. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
    1. Edelman AB, Cherala G, Blue SW, Erikson DW, Jensen JT. Impact of obesity on the pharmacokinetics of levonorgestrel‐based emergency contraception: single and double dosing. Contraception 2016;94:52‐7. - PMC - PubMed
    1. Fine P, Mathe H, Ginde S, Cullins V, Morfesis J, Gainer E. Ulipristal acetate taken 48–120 hours after intercourse for emergency contraception.. Obstet Gynecol 2010;115:257‐63. - PubMed

References to other published versions of this review

    1. Cheng L, Gülmezoglu M, Ezcurra E, Look PFA. Interventions for emergency contraception. Cochrane Database of Systematic Reviews 1999, Issue 7. [DOI: 10.1002/14651858.CD001324.pub4] - DOI - PubMed
    1. Cheng L, Gülmezoglu M, Oel CJ, Piaggio G, Ezcurra E, Look PFA. Interventions for emergency contraception. Cochrane Database of Systematic Reviews 2004, Issue 7. [DOI: 10.1002/14651858.CD001324.pub4] - DOI - PubMed
    1. Cheng L, Gülmezoglu M, Piaggio GP, Ezcurra E, Look PFA. Interventions for emergency contraception. Cochrane Database of Systematic Reviews 2008, Issue 4. [DOI: 10.1002/14651858.CD001324.pub4] - DOI - PubMed
    1. Cheng L, Che Y, Gülmezoglu AM. Interventions for emergency contraception. Cochrane Database of Systematic Reviews 2012, Issue 8. [DOI: 10.1002/14651858.CD001324.pub4] - DOI - PubMed

MeSH terms

LinkOut - more resources