Continuation of the etonogestrel implant in women undergoing immediate postabortion placement

Abstract

Objective-To estimate whether women who receive an immediate postabortion etonogestrel subdermal implant have higher discontinuation rates than women who undergo an interval insertion (insertion not associated with a recent pregnancy).Methods-This was a secondary analysis of the Contraceptive CHOICE Project. We compared 12-month continuation rates for the subdermal implant between women undergoing immediate postabortion placement and women who underwent an interval placement. Continuation rates were compared using Kaplan-Meier estimator of survival function and Cox proportional hazard models.Results-Over the study period, 141 women received the implant immediately postabortion and 935 women underwent an interval placement. The 12-month continuation rates were similar; 81.5% among women undergoing immediate postabortion placement and 82.8% among women undergoing interval placement (p=0.54). In the survival analysis, women who received an immediate postabortion implant were no more likely to discontinue their method than women who had an interval placement (adjusted HR 1.04, 95% CI 0.68-1.60). The most common reason given for discontinuation was frequent or irregular bleeding, which was reported by 65.4% of women discontinuing in the immediate postabortion group and 56.7% in the interval group.Conclusion-Women who undergo immediate postabortion placement of the subdermal implant have high rates of continuation that are equivalent to women undergoing interval insertion. Immediate postabortion LARC should be available to women undergoing induced abortion to decrease the risk of repeat unplanned pregnancy.

Prevalence and factors associated with early discontinuation rate of Implanon utilization among women who ever used Implanon in Kucha District Gamo Gofa Zone, Southern Ethiopia

“…On the other hand, the result was higher than the studies conducted in Nigeria (26.1%), Tigray region (16%), and Malaysia (22.86%) [9,14,15]. This might be due to the educational status of the study participants [14,15], low male partners' involvement, and low practice of discussion with partners before the Implanon insertion [18]. Implanon as compared to women who developed side effects which is similar with the study done at Durame Town, Southern Ethiopia, Debre Markose, Northwest Ethiopia and Egypt [9,16,19,20].…”

“…his might be due to inadequate follow-up counseling and unexpected side effects of the method. On the other hand, the result was higher than the studies conducted in Nigeria (26.1%), Tigray region (16%), and Malaysia (22.86%) [9,14,15]. This might be due to the educational status of the study participants [14,15], low male partners' involvement, and low practice of discussion with partners before the Implanon insertion [18].…”

“…An education, parity, side effects, and dissatisfaction of services and irregularity of menses were the major factors associated with early discontinuation of Implanon utilization among women aged between 15 and 49 years. Also, non-medical reasons such as planned pregnancy, plan to conceive in the near future and divorce, age, ethnicity, parity, socioeconomic factors were the common factor for Implanon discontinuation [10,12,13,9,[14][15][16]. Therefore, this study aimed to assess the prevalence and factors associated with early discontinuation of Implanon among women who ever used Implanon in Kucha district, Gamo Gofa Zone, Southern Ethiopia.…”

Who has a repeat abortion? Identifying women at risk of repeated terminations of pregnancy: analysis of routinely collected health care data

“…Published evidence showed that the continuation rate of Implanon ® after 2 years was 47% in a Scottish population 25. A possible explanation for this is that these LARC methods are known to have side effects such as irregular bleeding, which have been found to be one of the main reasons for their discontinuation 26 27. Furthermore, missed appointments and irregular bleeding are the main reasons for poor continuation rates of Depo-Provera 28.…”

Society of Family Planning clinical recommendations: contraception after surgical abortion

“…For women who receive immediate postabortion IUDs and implants, method satisfaction and continuation rates are high (GRADE 1B) [67,[70][71][72]. In two prospective studies, the subdermal implant continuation rates at 12 months were similar for women who had the implant placed immediately after abortion and women who had an interval placement [70,72].…”