Reasons for Early Removal of the Etonogestrel Subdermal Implant in Obese Women [A35

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INTRODUCTION: To evaluate women's reasons for electing early removal of the etonogestrel subdermal implant (EI) across body mass index (BMI) classes. METHODS: This is a retrospective chart review between January 2010 and December 2019 in a large health system which evaluated women’s reasons for early removal of the EI. Early removal was defined as removal less than 2.5 years after insertion. The reasons for removal as documented by providers were manually abstracted from the electronic health record. Listed reasons included abnormal uterine bleeding (AUB), desire to conceive (DTC), perceived weight gain, and implant complications. The subjects were grouped by BMI class and a test of trend analysis was performed for each of the reasons for removal. RESULTS: The cohort included 1,433 women, of whom 36% were normal/underweight, 25% were overweight, and 39% were obese. The trend for early removal secondary to AUB decreased with increasing BMI class: 64.0% in the normal/underweight group, 60.6% in overweight, 45.9% in class I obese, 41.7% in class II obese, and 40.5% in class III obese group (P<.0001). The trend for early removal secondary to perceived weight gain, desire to conceive, and implant complications increased with increasing BMI. CONCLUSION: Women with obesity were less likely to have the EI removed early due to AUB, but they were more likely to have it removed early because of the desire to conceive, perceived weight gain, and implant complications. This information will be helpful in counseling women with obesity regarding the use of the EI for long-acting reversible contraception.