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  1. 1
    135442
    Peer Reviewed

    Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception.

    World Health Organization [WHO]. Special Programme of Research, Development, and Research Training in Human Reproduction. Task Force on Postovulatory Methods of Fertility Regulation

    Lancet. 1998 Aug 8; 352(9126):428-33.

    A previous study suggested that provision of two 0.75 mg doses of levonorgestrel for emergency contraception caused less nausea and vomiting and was more effective than the Yuzpe regimen of combined oral contraceptives (two doses of 100 mcg of ethinyl estradiol and 0.5 mg of levonorgestrel). These two regimens were evaluated further in a double-blind, randomized World Health Organization study of 1998 women recruited from 21 centers worldwide who requested emergency contraception within 72 hours of unprotected intercourse. Among the 1955 women for whom the outcome was known, the crude pregnancy rate was 1.1% (11/976) in the levonorgestrel group and 3.2% (31/979) in the Yuzpe group. The crude relative risk of pregnancy for levonorgestrel compared with the Yuzpe regimen was 0.36 (95% confidence interval, 0.18-0.70). The proportion of pregnancies prevented was 85% in the former group and 57% in the latter group. Nausea and vomiting occurred significantly less frequently in the levonorgestrel group (23.1% and 5.6%, respectively) than in the Yuzpe regimen group (50.5% and 18.8%, respectively). The efficacy of both treatments declined significantly (p = 0.01) with increasing time since unprotected intercourse. These findings confirm that the levonorgestrel regimen may be more effective and is better tolerated than the current standard in emergency contraception.
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  2. 2
    135130

    Emergency contraception: a guide for service delivery.

    World Health Organization [WHO]. Division of Reproductive Health (Technical Support). Family Planning and Population

    Geneva, Switzerland, WHO, Division of Reproductive Health (Technical Support), Family Planning and Population, 1998. 60 p. (WHO/FRH/FPP/98.19)

    The introduction of emergency contraception into family planning programs and its distribution through both clinical and nonclinical channels have been urged to prevent the serious health and socioeconomic consequences of unwanted pregnancies. The need for emergency contraception is especially high among adolescents, who may become sexually active before they are informed about contraception or have access to appropriate services. The provision of emergency contraceptive methods through official family planning programs should be regarded as key to the long-term international strategy of upgrading reproductive health care. Moreover, when service outlets offer emergency contraception information and care, they can serve as a first contact point where sexually active men, women, and teens can receive other reproductive health services or referrals. This booklet, prepared by the World Health Organization for service delivery personnel, presents information on emergency contraceptive pills, the use of copper-releasing IUDs as emergency contraception, service delivery aspects, the introduction of emergency contraception in reproductive health programs, and information dissemination. An appendix sets forth medical eligibility criteria.
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