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Review: the levonorgestrel releasing intrauterine system prevents more pregnancies than intrauterine devices (IUDs) ≤250 mm2 but not IUDs >250 mm2

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 QUESTION: In women of reproductive age, is the levonorgestrel releasing (20 μg/d) intrauterine system (LNG-20) more effective and tolerable than other reversible contraceptive methods?

Data sources

Studies were identified using Medline, EMBASE/Excerpta Medica, PsycLIT, POPLINE, Cochrane Controlled Trials Register, and specialist databases between January 1974 and July 1998. Bibliographies of relevant articles were also reviewed. Experts in the field and organisations were contacted for unpublished data.

Study selection

Randomised controlled trials were selected if participants were women of reproductive age, they compared LNG-20 with another reversible contraceptive, and they had predetermined outcomes.

Data extraction

Data were extracted on predetermined outcomes of pregnancy as a result of method or user failure and continuation of contraceptive method. Data on these outcomes were extracted when either number of events per women months or single decrement life table probabilities were reported.

Main results

5 studies met the inclusion criteria. LNG-20 was compared with 2 groups of intrauterine devices (IUDs), …

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  • Source of funding: NHS R&D Health Technology Assessment Programme.

  • For correspondence: Dr R French, Department of Sexually Transmitted Diseases, Royal Free and University College Medical School, Mortimer Market Centre, off Capper Street, London WC1E 6AU, UK. Fax + 44 (0)207 679 9669.