Experience with Implanon® in a north-east London family planning clinic

Abstract

Aim The primary objective of the study was to evaluate the continuation rates of a relatively new long-acting method of contraception, Implanon®. The secondary objective was to study discontinuations related to bleeding problems and their management.Method A retrospective review of records of women fitted with Implanon was undertaken during February 2000–January 2003.Results Results from the secondary objective will be the subject of a separate communication. Of the 147 implants fitted, 132 records could be retrieved; of these, 97% of the women had pre-insertion counselling by the clinician. The most common indications for Implanon usage were choice of a long-acting method, unhappy experience with other contraceptive methods and suboptimal compliance with contraceptive pills and injectables. The median age of fitting was 25 years and 36% of the women were nulliparous. No problems were experienced with fitting or removal of implants. Twenty (15%) women were lost to follow-up. Twenty-two implants were removed by the end of the study period, with 12 (60%) removals attributed to prolonged heavy/light bleeding. There were no known pregnancies during the study. Given that 15% of the women could not be followed up or contacted, the assumed lifetimes of Implanon using the Kaplan–Meier method are 0.90 (95% confidence interval 0.82–0.95) at 12 months, 0.80 (0.67–0.88) at 24 months and 0.75 (0.58–0.85) at 35 months. The confirmed lifetimes are 0.84 (0.71–0.91) at 12 months, 0.63 (0.42–0.78) at 24 months and 0.53 (0.28–0.73) at 35 months.Conclusion Although not free of side-effects, Implanon can be a good choice for women who are properly informed and counselled and seek long-term ‘forgettable’ contraception.