Ovarian cysts in users of Implanon® and Jadelle® subdermal contraceptive implants

Abstract

Objective To evaluate the prevalence of ovarian cysts in users of two contraceptive implants compared to users of intrauterine contraceptive (IUC). Materials and Methods A total of 344 women were enrolled at 3 months of use of the etonogestrel-releasing implant (Implanon®), the levonorgestrel-releasing implant (Jadelle®) or the TCu380A IUC. Bimanual pelvic examination and vaginal ultrasound were performed during routine 3-, 6- and 12-month visits of asymptomatic women. Women with ovarian cysts (or enlarged ovarian follicles ≥25 mm) were assessed weekly until disappearance or reduction of the image [including estradiol (E 2) and progesterone (P) measurement], and women with no ovarian enlargement underwent the same evaluation for the same period of time. Results Ovarian cysts were detected in 5.2%, 13.0% and 1.9% of users of Implanon®, Jadelle® and IUC, respectively, at 3 months. At 6 months of use, prevalence was 7.2%, 8.0% and 2.1%, whereas 12-month rates were 26.7%, 14.6% and 1.2% in the three groups, respectively. E 2 levels were significantly higher among users with ovarian cysts than controls. The time until disappearance of the ovarian cyst was similar in all three groups. There were more cases of menorrhagia in users of implants who had ovarian cysts than in those with no ovarian enlargement. Conclusions The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon® and Jadelle® implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.