A 32 year old female who has completed her wants to know more about contraception and the risk of ectopic pregnancies. Which of the following contraceptive methods increase the absolute risk of ectopic pregnancies?
A. Combined oral contraceptive pills (COCP)
B. Intrauterine system (Mirena coil)
C. Progestogen-only Pill (POP)
D. Progesterone-only implant (Nexplanon)
E. None of the above
This question by the examiners is written purely to test your knowledge of absolute and relative risk. You would need to know a little on the background of intrauterine systems. The absolute risk of ectopic pregnancy with the mirena coil is decreased but the relative risk is increased. Meaning if you were to become pregnant while on the mirena coil, the risk of it being an ectopic is higher as compared to if you were to become pregnant while you were not on the mirena coil. The risk of ectopic pregnancy when using IUDs is lower than when using no contraception.
The overall risk of ectopic pregnancy when using the IUD is very low, at about 1 in 1000 in 5 years. If a woman becomes pregnant with the IUD in situ, the risk of ectopic pregnancy is about 1 in 20.