Sex, Infertility and Contraception Quiz

See Contraception. Option E is correct because the copper intrauterine device (Cu-IUD), often called the copper coil, is the most effective method of emergency contraception, with an overall pregnancy rate of less than 0.1%, and it can be left in place afterwards as ongoing contraception. It works mainly because copper is toxic to sperm and eggs, which stops fertilisation, and it also affects the lining of the womb and so may prevent implantation. It can be inserted within 5 days (120 hours) of the first unprotected intercourse in a cycle, or within 5 days of the earliest estimated ovulation, whichever is later. Sperm can survive in the female genital tract for about 5 days, so the fertilisation window is long. The two oral methods work differently. Levonorgestrel (a progestogen) is thought to delay or prevent ovulation, is licensed for use within 72 hours, and becomes ineffective in the late follicular phase. Ulipristal acetate (a progesterone receptor modulator) suppresses the luteinising hormone surge and can still delay ovulation later than levonorgestrel can, and it is licensed for use within 5 days. Most women will ovulate later in the cycle after either pill, so they remain at risk from further sex. The one-line version is that the copper coil is the most effective emergency method and also continues as contraception.

• Most effective: the copper intrauterine device has an overall pregnancy rate of less than 0.1%.
• Ongoing cover: it can be left in place afterwards as ongoing contraception.
• Timing: it can be inserted within 5 days (120 hours) of the first unprotected intercourse in a cycle.