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  • Comment on ‘An emergency contraception algorithm based on risk assessment: changes in clinicians’ practice and patients’ choices’

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Letters to the editor
Comment on ‘An emergency contraception algorithm based on risk assessment: changes in clinicians’ practice and patients’ choices’
  1. Aisling Baird, FRCOG, MFSRH
  1. Anne Webb, FFSRH
  1. Consultant in Sexual and Reproductive Healthcare, Liverpool Community Health, Liverpool, UK; aisling.baird@liverpoolch.nhs.uk
  2. Retired Consultant in Sexual and Reproductive Healthcare, Liverpool, UK

https://doi.org/10.1136/jfprhc-2013-100725

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    Congratulations to Drs McKay and Gilbert on trying to increase access to emergency contraception (EC) intrauterine device (IUD) and on achieving high rates.1 Even in Liverpool, UK where we pride ourselves on easy, often immediate, IUD access and where we have long been promoting its effectiveness we only achieve around 5%.

    We have some concerns about the algorithm described in this article.1 The classification of level of risks is not based on what is known about variability of ovulation timing. The chance of pregnancy is greater than 10% from Day 6 to Day 21 of the cycle, and by the fifth week women still have a 4–6% chance of ovulating.2 Contrary to previous teaching, only 10% of women with a 28-day cycle will ovulate 14 days before their next bleed.2 Previous …

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    Footnotes

    • Competing interests None.

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