EC Info

Dear ProLife Colleague,

Here is some information on EC that you may not know:

Note the article in the June 5 New York Times on Emergency Contraception

In overview, the reason for the article is this: The FDA drug labeling suggests that Plan B may inhibit implantation as well as delay ovulation. When approved in 1999, that was a politically correct conclusion: “take the EC, it will work somehow!” That the post-fertilization action would be abortifacient became more widely realized, especially in recent years. Many doctors won’t prescribe an abortifacient drug, and so won’t prescribe EC. And the HHS Contraception Mandate requires that we do. Suddenly, the post fertilization potential effect became a practical and a “conscience” downside. Not so politically correct now. So the “scientists” have hurried up to document that the literature does not substantiate post fertilization effect. And they are asking the FDA to change the labeling. Political correctness, not science, drives this NYT article. Fact is, current science cannot conclusively prove, nor disprove, Plan B’s abortifacient action.

The NYT article also mentions that James Trussel, a leading EC expert, says Plan B effectiveness is actually 52%, not 89% as noted on the drug literature. (wait and see if THAT gets changed in the drug literature). Plan B sells for between $40 and $50, which a desperate woman (or man) will pay. It contains 1.5 mg of levonorgestrel, an inexpensive drug—consider that 21 pills of alesse, a standard birth control pill, contain a total of 2.1 mg of levonorgestrel, (plus the estrogen component) and the generic sells for about $18. The profit margin for Plan B is double. Desperation will pay money… Effectiveness may be 52%, if taken in the 5 day pre-ovulatory window when it will be effective (day 8 thru 12 of a 28 day cycle) It is no bargain, no matter how you look at it.

Did you know that Plan B delays ovulation only if given in the 5 days before the 48 hour luteal peak window? It does not work if given on day 1 to 7 of a 28 day cycle. And it does not work if given during the LH surge, or after ovulation. How many times is Plan B taken in the correct window of time? Further, it is often mentioned that Plan B will thicken the cervical mucus to slow sperm transport. Bizarre idea. The sperm is through the cervical mucus minutes after coitus, long before any mucus change takes place.

Ella, on the other hand, is different from, and more effective than Plan B. It is a progesterone blocker with a long half-life, and it affects the function of the secretory endometrium. And there is also evidence that it affects the CL function after ovulation. By these two mechanisms, it will undoubtedly adversely affect implantation (abortifacient action), which is why it can be effectively used up to 5 days after intercourse (when Plan B is useless). This fact is well noted, but the literature generally does not mention the possibility ofå abortifacient action.