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Embracing post-fertilisation methods of family planning: a call to action
  1. Elizabeth G Raymond1,
  2. Francine Coeytaux2,
  3. Kristina Gemzell-Danielsson3,
  4. Kirsten Moore4,
  5. James Trussell5,
  6. Beverly Winikoff6
  1. 1Senior Medial Associate, Gynuity Health Projects, New York, NY, USA
  2. 2Project Director, Public Health Institute, Oakland, CA, USA
  3. 3Professor, Department of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
  4. 4Consultant, Reproductive Health Technologies Project, Washington, DC, USA
  5. 5Professor of Economics and Public Affairs, Office of Population Research, Princeton University, Princeton, NJ, USA and Visiting Professor, The Hull York Medical School, Hull, UK
  6. 6President, Gynuity Health Projects, New York, NY, USA
  1. Correspondence to Dr Elizabeth G Raymond, Gynuity Health Projects, 15 East 26th Street, Suite 801, New York, NY 10010, USA; eraymond{at}gynuity.org

https://doi.org/10.1136/jfprhc-2013-100702

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    ABSTRACT

    Family planning methods that act when administered after fertilisation would have substantial benefits: they could be used longer after sex than current emergency contraceptives, and potentially a woman could use them only on relatively rare occasions when her menstrual period is delayed. Although such methods would displease abortion opponents, they would likely be welcomed by many women. Research to develop post-fertilisation fertility control agents should be pursued.

    Background

    Family planning methods that act after fertilisation have considerable appeal. Compared to currently available contraceptives, which are all designed primarily to keep sperm and egg apart, drugs that would act during or after union of these gametes might offer notable advantages. If used postcoitally, such drugs would be effective later after sex than emergency contraceptives that work only if taken before ovulation,1 and therefore they could serve more women and provide more benefit at a population level. A woman could potentially use a post-fertilisation method on a planned schedule only once in each menstrual cycle, no matter how many prior coital acts she had had in that cycle. If the drug were effective when administered after implantation of an embryo, timing would be flexible, and she might even be able to limit its use on average to a few times a year when her menstrual period was late. Importantly, post-fertilisation methods would eliminate the conceptual and logistical challenge of needing to obtain and initiate contraception before having sex, which …

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    Footnotes

    • Funding James Trussell's work on this paper was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development grant for Infrastructure for Population Research at Princeton University (Grant R24HD047 879).

    • Competing interests None.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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      British Medical Journal Publishing Group
      BMJ Sexual & Reproductive Health 2013; 39 235-235 Published Online First: 23 Sep 2013. doi: 10.1136/jfprhc-2013-100779