IUCD with highest incidence of ectopic pregnancy is :
**Core Concept**
The question is testing the ability to identify the intrauterine contraceptive device (IUCD) associated with the highest risk of ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often in the fallopian tube.
**Why the Correct Answer is Right**
The copper-releasing IUCD (Cu IUCD) has been shown to have a higher risk of ectopic pregnancy compared to other types of IUCDs. This is likely due to the copper ions released by the IUCD, which may damage the sperm and increase the risk of fertilization occurring outside the uterus. The Cu IUCD is also associated with a higher risk of pelvic inflammatory disease (PID), which can further increase the risk of ectopic pregnancy.
**Why Each Wrong Option is Incorrect**
* **Option A:** The progesterone-releasing IUCD (Mirena) is actually associated with a lower risk of ectopic pregnancy compared to the Cu IUCD, as it works by thickening the cervical mucus and making it more difficult for sperm to reach the egg.
* **Option B:** The levonorgestrel-releasing IUCD (LNG-IUCD) also has a lower risk of ectopic pregnancy compared to the Cu IUCD, as it works by thinning the uterine lining and making it more difficult for the fertilized egg to implant.
* **Option D:** The inert IUCD (copper-free) is not associated with a higher risk of ectopic pregnancy, as it does not release any hormones or ions that could damage the sperm or increase the risk of fertilization occurring outside the uterus.
**Clinical Pearl / High-Yield Fact**
It's essential to note that while the Cu IUCD has a higher risk of ectopic pregnancy, it is still a highly effective form of contraception and is associated with a lower risk of ectopic pregnancy compared to other forms of contraception, such as the pill or patch.
**Correct Answer:** C.