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Comparative contraceptive effectiveness of levonorgestrel-releasing and copper intrauterine devices: the European Active Surveillance Study for Intrauterine Devices.
Contraception 2015; 91(4):280-3C

Abstract

OBJECTIVES

The objective was to measure the rate of unintended pregnancies in women using levonorgestrel-releasing intrauterine systems (LNG IUSs, releasing 20 mcg LNG daily) and copper intrauterine devices (IUDs) in a typical population of IUD users and to describe associated complications.

METHODS

A multinational, prospective, non-interventional cohort study of new users of LNG IUS and copper IUDs was performed. Following a baseline survey, study participants and their physicians completed one follow-up questionnaire after 12 months. A multifaceted four-level follow-up procedure minimized loss to follow-up. Patient-reported outcomes were validated by the treating physicians.

RESULTS

A total of 61,448 women with a newly inserted IUD were enrolled in six European countries between 2006 and 2012. The copper IUD cohort contained more than 30 different types. Validated 1-year follow-up information for 58,324 users between 18 and 50 years of age (70% using LNG IUS, 30% using copper IUDs) was collected. A total of 118 contraceptive failures occurred (26 LNG, 92 copper). Both types of IUD were highly effective, with overall Pearl indices of 0.06 [95% confidence interval (CI): 0.04-0.09] and 0.52 (95% CI: 0.42-0.64) for LNG IUS and copper IUDs, respectively. The adjusted hazard ratio for LNG IUS vs. copper IUDs was 0.16 (95% CI: 0.10-0.25). Tenty-one pregnancies (7 LNG IUS, 14 copper IUD) were ectopic, yielding an adjusted hazard ratio for ectopic pregnancy of 0.26 (95% CI: 0.10-0.66).

CONCLUSIONS

The contraceptive failure rate was low with both IUDs. However, the LNG IUS was associated with a significantly lower risk of pregnancy, including ectopic pregnancy, than the copper IUDs.

IMPLICATIONS

To our knowledge, this is the first large-scale, multinational, prospective epidemiological study to measure and compare the contraceptive effectiveness of LNG IUSs and copper IUDs during routine clinical practice. Clinicians and patients should be aware of differences in rates of unintended pregnancies and associated complications in relation to IUD us.

Authors+Show Affiliations

ZEG-Berlin, Chausseestrasse 115, 10115 Berlin, Germany. Electronic address: k.heinemann@zeg-berlin.de.ZEG-Berlin, Chausseestrasse 115, 10115 Berlin, Germany.ZEG-Berlin, Chausseestrasse 115, 10115 Berlin, Germany.ZEG-Berlin, Chausseestrasse 115, 10115 Berlin, Germany.

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

25601350

Citation

Heinemann, Klaas, et al. "Comparative Contraceptive Effectiveness of Levonorgestrel-releasing and Copper Intrauterine Devices: the European Active Surveillance Study for Intrauterine Devices." Contraception, vol. 91, no. 4, 2015, pp. 280-3.
Heinemann K, Reed S, Moehner S, et al. Comparative contraceptive effectiveness of levonorgestrel-releasing and copper intrauterine devices: the European Active Surveillance Study for Intrauterine Devices. Contraception. 2015;91(4):280-3.
Heinemann, K., Reed, S., Moehner, S., & Minh, T. D. (2015). Comparative contraceptive effectiveness of levonorgestrel-releasing and copper intrauterine devices: the European Active Surveillance Study for Intrauterine Devices. Contraception, 91(4), pp. 280-3. doi:10.1016/j.contraception.2015.01.011.
Heinemann K, et al. Comparative Contraceptive Effectiveness of Levonorgestrel-releasing and Copper Intrauterine Devices: the European Active Surveillance Study for Intrauterine Devices. Contraception. 2015;91(4):280-3. PubMed PMID: 25601350.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative contraceptive effectiveness of levonorgestrel-releasing and copper intrauterine devices: the European Active Surveillance Study for Intrauterine Devices. AU - Heinemann,Klaas, AU - Reed,Suzanne, AU - Moehner,Sabine, AU - Minh,Thai Do, Y1 - 2015/01/16/ PY - 2014/10/02/received PY - 2015/01/08/revised PY - 2015/01/12/accepted PY - 2015/1/21/entrez PY - 2015/1/21/pubmed PY - 2015/12/17/medline KW - Copper KW - EURAS IUD KW - Ectopic pregnancy KW - Intrauterine device (IUD) KW - Levonorgestrel (LNG) SP - 280 EP - 3 JF - Contraception JO - Contraception VL - 91 IS - 4 N2 - OBJECTIVES: The objective was to measure the rate of unintended pregnancies in women using levonorgestrel-releasing intrauterine systems (LNG IUSs, releasing 20 mcg LNG daily) and copper intrauterine devices (IUDs) in a typical population of IUD users and to describe associated complications. METHODS: A multinational, prospective, non-interventional cohort study of new users of LNG IUS and copper IUDs was performed. Following a baseline survey, study participants and their physicians completed one follow-up questionnaire after 12 months. A multifaceted four-level follow-up procedure minimized loss to follow-up. Patient-reported outcomes were validated by the treating physicians. RESULTS: A total of 61,448 women with a newly inserted IUD were enrolled in six European countries between 2006 and 2012. The copper IUD cohort contained more than 30 different types. Validated 1-year follow-up information for 58,324 users between 18 and 50 years of age (70% using LNG IUS, 30% using copper IUDs) was collected. A total of 118 contraceptive failures occurred (26 LNG, 92 copper). Both types of IUD were highly effective, with overall Pearl indices of 0.06 [95% confidence interval (CI): 0.04-0.09] and 0.52 (95% CI: 0.42-0.64) for LNG IUS and copper IUDs, respectively. The adjusted hazard ratio for LNG IUS vs. copper IUDs was 0.16 (95% CI: 0.10-0.25). Tenty-one pregnancies (7 LNG IUS, 14 copper IUD) were ectopic, yielding an adjusted hazard ratio for ectopic pregnancy of 0.26 (95% CI: 0.10-0.66). CONCLUSIONS: The contraceptive failure rate was low with both IUDs. However, the LNG IUS was associated with a significantly lower risk of pregnancy, including ectopic pregnancy, than the copper IUDs. IMPLICATIONS: To our knowledge, this is the first large-scale, multinational, prospective epidemiological study to measure and compare the contraceptive effectiveness of LNG IUSs and copper IUDs during routine clinical practice. Clinicians and patients should be aware of differences in rates of unintended pregnancies and associated complications in relation to IUD us. SN - 1879-0518 UR - https://www.unboundmedicine.com/medline/citation/25601350/Comparative_contraceptive_effectiveness_of_levonorgestrel_releasing_and_copper_intrauterine_devices:_the_European_Active_Surveillance_Study_for_Intrauterine_Devices_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010-7824(15)00012-8 DB - PRIME DP - Unbound Medicine ER -