CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-07). The draft was written by AI, the existence of all 1 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.7.
Verdict No. 2393 · Search date 2026-08-07 · Methodology v0.7

Levonorgestrel intrauterine device,
does it really help with Emergency contraception within five days after unprotected intercourse?

30-Second Summary
C
Evidence Grade C · 56 · Safety caution
Pregnancy was similarly uncommon versus copper, but the noninferiority margin was a design value rather than a validated clinical threshold
Professional insertion is required and can cause pain, bleeding, expulsion, infection, and rare perforation. Failure pregnancy requires prompt assessment for ectopic pregnancy and risks of continuing pregnancy with an IUD in place.
What the
research shows
The grade is C. In a 711-participant noninferiority trial against the copper T380A IUD, one-month pregnancy occurred in 1/317 (0.3%) versus 0/321, risk difference 0.3 percentage points (95% CI -0.9 to 1.8). The interval stayed inside the prespecified 2.5-point margin, but that margin was a design value, not an externally validated minimum important difference.
What the
ads claim
It was not tested directly against oral emergency contraception. Claims must remain limited to IUD-seeking adults aged 18 to 35 treated within five days.
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Useful facts when choosing a product

  • Medical care for adverse events within one month occurred in 5.2% versus 4.9%.
  • Insertion pain, cramping, bleeding, infection, perforation, and expulsion are relevant; pregnancy after failure requires urgent evaluation for ectopic pregnancy and risks of pregnancy with an IUD in place.
  • The single failure followed intercourse 48 hours before placement and ended in spontaneous abortion at 10 weeks with the IUD in place.
Gap Measurement · Verdict 2393 · C 56
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

RAPID EC masked participants, while inserters necessarily knew device type. The analysis plan changed after trial completion from intention-to-treat to modified intention-to-treat; this post-trial change was treated as an avoidable analysis limitation. Only 7% of 10,317 people screened enrolled, mostly because others wanted oral emergency contraception rather than an IUD. Sites purchased Liletta and ParaGard from distributors; devices were not donated. Funding came from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the University of Utah Population Health Research Foundation, and NIH clinical and translational support. Verdict 704 is B with 72 points for oral levonorgestrel, and verdict 744 is B with 73 points for oral ulipristal. Those are pills; this verdict concerns an inserted 52 mg device that also provides ongoing contraception.

02

Why this is classified as C (56)

A randomized trial found a low hard-outcome failure rate, but single-trial, noninferiority, and active-control limitations give C with 56 points.

Counterpoint. Only 290 versus 300 supplied an actual one-month urine test; survey and medical records filled other outcomes, so this was not an all-randomized analysis.

Rejudgment record. Cross-check applied — Cross-check of primary analysis denominators, risk difference, nature of the noninferiority margin, device purchasing, funding, and oral emergency-contraception verdicts

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationR1Single confirmatory trial
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeE+Meets the clinically important threshold

The scoring table and the verdict agree (C).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Emergency contraception versus a copper IUDCOne noninferiority trial found 0.3% versus 0%.
Superiority over oral emergency contraception?No direct randomized comparison was performed.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Participant-masked active-control randomized noninferiority trial321NICHD, University of Utah Population Health Research Foundation, and NIH clinical and translational supportPregnancy one month after insertion1/317 (0.3%) vs 0/321; risk difference 0.3 points (95% CI -0.9 to 1.8); margin 2.5 pointsOnly direct randomized trial
§

Receipt — 1 References

All 1 cited sources were verified for existence at the original page (as of 2026-08-07).

Turok DK, Gero A, Simmons RG, et al. Levonorgestrel vs. Copper Intrauterine Devices for Emergency Contraception. N Engl J Med. 2021;384:335-344. PMID: 33503342. DOI: 10.1056/NEJMoa2022141.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-07 · Corrections: none

Cite this verdict

Levonorgestrel intrauterine device x emergency contraception Evidence Grade C card
[Chamgap] Levonorgestrel intrauterine device x emergency contraception — Evidence Grade C·56. 1 cited sources checked. Source: https://chamgap.com/en/verdicts/womens/levonorgestrel-iud-emergency-contraception/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

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