Contraceptive Pearl: Does Your Patient Need Backup Contraception After Progestin IUD Placement?

Written by Hannah Rosenfield, M.D.

In the past, we suggested backup contraception for 1 week after insertion of a progestin IUD. Is this still necessary?

A recent study examined one-month pregnancy rates among individuals who had an IUD placed as emergency contraception and reported intercourse within 7 days post-placement. This analysis included 268 participants who received the levonorgestrel IUD and 273 participants who received the copper IUD. Of the participants who started intercourse within 7 days of IUD placement (levonorgestrel group 138, 66.4%; copper group 148, 66.4%), only 16.4% used condoms or withdrawal. In the secondary analysis, no pregnancies occurred in either group.

In light of these new data, we no longer need to advise patients to use backup contraception after insertion of a 52-mg progestin IUD.


Your Birth Control Choices Fact Sheet

Progestin IUD User Guide

Copper IUD User Guide

IUD Fact Sheet


Fay KE, Clement AC, Gero A, KaiserJE, Sanders JN, BakenRa AA, & Turok DK. Rates of pregnancy among levonorgestrel and copper intrauterine emergency contraception initiators: Implications for backup contraception recommendations. Contraception. 2021;104(5):561-566. doi:10.1016/j.contraception.2021.06.011.

Turok DK, Gero A, Simmons RG, Kaiser JE, Stoddard GJ, Sexsmith CD, Gawron LM, Sanders JN. Levonorgestrel vs. copper intrauterine devices for emergency contraception. N Engl J Med. 2021;384:335-344. doi: 10.1056/NEJMoa2022141.


The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.