Unplanned Pregnancy Following Norplant Removal in Adolescents and Adults

Abstract

Background Norplant is a user-independent subdennal contraceptive composed of six silastic, levonorgestrel containing capsules. Previously reported data demonstrated that the majority of women in our population chose Norplant within one year of a pregnancy (89% of adolescents and 69% of adults); 65% of these women initially became pregnant while using oral contraceptives. The purpose of this study is to prospectively compare the length of time between Norplant removal and unplanned pregnancy in adolescent ( Methods Women using Norplant are prospectively followed from device insertion through removal and subsequent annual examinations as part of an ongoing study. Patient data is collected by personal interview and chart review and entered into a computer database. Data is evaluated for significance by chi-square analysis where p Results Post-removal follow-up data for between 11 and 62 months is currently available for 367 Norplant removals (125 adolescents, 212 adults, and 30 individuals with incomplete data). The average length of follow-up is 24.8 months with a standard deviation of 9.9 months. There have been 41 pregnaneies to date following Norplant removal (18 adolescents and 23 adults). Thirty six (88%) of these pregnancies were unplanned (15 adolescents and 21 adults). The average length of time from device removal to unplanned pregnancy was 4.7 months in adolescents and 5.3 months in adults. Eighty seven percent of adolescent and 57% of adult unplanned pregnancies occurred following device removal despite placement on oral contraceptives. Conclusions Adolescent women discontinuing Norplant use are no more likely to experience unplanned pregnancy than adults. Women experiencing oral contraceptive failure are likely to experience repeat oral contraceptive failure. In this population, user dependent contraceptive methods are less reliable than user independent contraceptive methods.