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‘Post-fertilisation’ contraception is viable say experts

Biggest hurdle to ‘after-sex’ pill is political not medical

Jo Carlowe

Monday, 23 September 2013

A contraceptive pill that could be routinely used after, rather than before, sex is probably scientifically viable, say experts.

Writing in the Journal of Family Planning and Reproductive Health Care, the researchers say such an advance would be welcomed by many women but the biggest hurdle to development is likely to be ‘political opposition’.

There would be many advantages to routine “post-fertilisation” contraception - as distinct from emergency contraception that has to be used within 72 hours - write the US and Swedish specialists in reproductive health, public health, and economics.

For one, this method could be used for far longer after sex than emergency contraception, so would serve a much wider number of women than are currently able to access emergency contraception and use it within the defined time window.

It would also be more convenient, offering the potential to be used just once in the monthly menstrual cycle, no matter how many times a woman had had sex before taking it, or even when a period had just been missed.

“Importantly, post-fertilisation methods would eliminate the conceptual and logistical challenge of needing to obtain and initiate contraception before having sex, which can be daunting for both women and men,” write the authors.

Although there are still technical hurdles to be overcome, the authors believe the pharmaceutical know-how to create an after-sex contraception already exists. 

“Multidisciplinary research may be needed to define the best option, but given our rapidly increasing understanding of reproductive physiology, ultimate success seems likely,” they say.

But they say political opposition is likely to pose a greater challenge as both the UK and US governments define the start of pregnancy as implantation of the fertilised egg and interruption of this afterwards as ‘abortion’.

Survey evidence suggests that women back the idea of post-fertilisation contraception, say the authors.

“Research from diverse settings has found that many women view medical abortion methods, particularly when used at home, as more natural and more compatible with their religious or ethical views than clinic or hospital based surgical procedures,” they write.

All that is lacking, writing the authors, are “intrepid” funders willing to kick-start the research.

“To meet the challenges of our increasingly complicated world, women deserve all possible options for controlling and preserving their reproductive health and lives,” they conclude.

In an accompanying podcast, lead author Elizabeth Raymond, senior medical associate at Gynuity Health Projects in New York, acknowledges the need to win over policy makers. Specialists working in family planning have their part to play, she suggests.

“We need to stop extolling pre-fertilisation contraception as a good thing, because it implies that something that works after fertilisation is bad.”

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