Contraceptive Methods Research Articles

Emerging approaches to male contraception.

Currently, approximately half of all pregnancies worldwide are unintended. Contraceptive use significantly reduces the risk of unintended pregnancy; however, options for men are particularly limited. Consequently, efforts are underway to develop novel, safe, and effective male contraceptives. This review discusses research into emerging male contraceptive methods that either inhibit sperm production or impair sperm function. It focuses on those in the preclinical or early clinical stages of development.

Priorities for contraceptive method and service delivery attributes among adolescent girls and young women in Kenya: a qualitative study.

Despite increasing global commitment to meeting the family planning needs of adolescent girls and young women (AGYW), there is limited research on how they prioritize contraceptive method and service delivery characteristics. In this qualitative study, we examine the specific elements that drive the contraceptive choices of Kenyan AGYW, and apply our findings to the development of attributes and levels for a discrete choice experiment (DCE). Our four-stage approach included data collection, data reduction, removing inappropriate attributes, and optimizing wording. Between June-October 2021, we conducted in-depth interviews with 30 sexually-active 15-24 year-old AGYW in Kisumu county, Kenya who were non-pregnant and desired to delay pregnancy. Interviews focused on priorities for contraceptive attributes, how AGYW make trade-offs between among these attributes, and the influences of preferences on contraceptive choice. Translated transcripts were qualitatively coded and analyzed with a constant comparative approach to identify key concepts. We developed and iteratively revised a list of attributes and levels, and pre-tested draft DCE choice tasks using cognitive interviews with an additional 15 AGYW to optimize comprehension and relevance. In-depth interview participants' median age was 18, 70% were current students, and 93% had a primary sexual partner. AGYW named a variety of priorities and preferences related to choosing and accessing contraceptive methods, which we distilled into six key themes: side effects; effectiveness; user control; privacy; source of services; and cost. Bleeding pattern was top of mind for participants; amenorrhea was generally considered an intolerable side effect. Many participants felt more strongly about privacy than effectiveness, though some prioritized duration of use and minimizing chance of pregnancy above other contraceptive characteristics. Most AGYW preferred a clinic setting for access, as they desired contraceptive counseling from a provider, but pharmacies were considered preferable for reasons of privacy. We selected, refined, and pre-tested 7 DCE attributes, each with 2-4 levels. Identifying AGYW preferences for contraceptive method and service delivery characteristics is essential to developing innovative strategies to meet their unique SRH needs. DCE methods may provide valuable quantitative perspectives to guide and tailor contraceptive counseling and service delivery interventions for AGYW who want to use contraception.

Effect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation

Research questionDo the various forms of hormonal and non-hormonal contraceptives have any association with ovarian stimulation outcomes, such as oocyte yield and maturation, in patients undergoing planned oocyte cryopreservation (POC)? DesignThis retrospective cohort study included all patients who underwent POC cycles between 2011 and 2023. The use of types of contraception before a POC cycle was recorded. The study evaluated the median number of cumulus–oocyte complexes obtained after vaginal oocyte retrieval and the proportion of metaphase II oocytes that underwent vitrification among all the cohorts. ResultsA total of 4059 oocyte freezing cycles were included in the analysis. Eight types of contraceptive method were recognized in patients undergoing ovarian stimulation: intrauterine device (IUD), copper (n = 84); IUD, levonorgestrel low dose (<52 mg) (n = 37); IUD, levonorgestrel (n = 192); subdermal etonogestrel implant (n = 14); injectable medroxyprogesterone acetate (n = 11); etonogestrel vaginal ring (n = 142); combined oral contraceptive pills (n = 2349); and norelgestromin transdermal patch (n = 10). The control group included patients not using contraceptives or using barrier or calendar methods (n = 1220). Among all the cohorts the median number of cumulus–oocyte complexes retrieved during oocyte retrieval was comparable (P = 0.054), and a significant difference in oocyte maturity rate with median number of vitrified oocytes was found (P = 0.03, P < 0.001, respectively). After adjusting for confounders a multivariate analysis found no association between the type of contraceptive and proportion of metaphase II oocytes available for cryopreservation. ConclusionsAmong the various forms of contraception, none was shown to have an adverse association with oocyte yield or maturation rate in patients undergoing POC.

Prenatal depression among pregnant women attending public health facilities in Babile district, Eastern Ethiopia: a cross-sectional study

BackgroundDepression during pregnancy is a significant health concern that can lead to a variety of short and long-term complications for mothers. Unfortunately, there is a lack of information available on the prevalence and predictors of prenatal depression in rural eastern Ethiopia. This study assessed prenatal depression and associated factors among pregnant women attending public health facilities in the Babile district, Eastern Ethiopia.MethodAn institution-based cross-sectional study was conducted among 329 pregnant women attending Babile District Public Health Facilities from November 1 to December 30, 2021. Bivariable and multivariable logistic regression were used to identify factors associated with prenatal depression. The adjusted odds ratio (AOR) with a 95% confidence interval was used to report the association, and the significance was declared at a p-value < 0.05.ResultsThe prevalence of prenatal depression was 33.1% (95% CI = 28.0%, 38.2%). A lower income (AOR = 3.85, 95% CI = 2.08, 7.13), contraceptive use (AOR = 0.53, 95% CI = 0.28, 0.98), unintended pregnancy (AOR = 2.24, 95% CI = 1.27, 3.98), history of depression (AOR = 5.09, 95% CI = 2.77, 9.35), poor social support (AOR = 5.08, 95% CI = 2.15, 11.99), and dissatisfied marriage (AOR = 2.37, 95% CI = 1.30, 4.33) were the factors associated with increased prenatal depression among pregnant women.ConclusionsOne in every three pregnant women in rural eastern Ethiopia had prenatal depression. Monthly income, contraceptive use, pregnancy intention, history of depression, social support, and marriage satisfaction status were the determinants of prenatal depression. Preventing unintended pregnancies by encouraging women to utilize modern contraceptive methods is essential for mitigating and controlling the risks and burdens of prenatal depression and its negative consequences.

Discontinuation of long-acting reversible contraceptive methods and associated factors among reproductive-age women in Shashemene town, Oromia, Ethiopia.

The early termination of long-acting reversible contraceptives (LARCs) raises issues for the healthcare system and has the potential to affect public health. Long-acting reversible contraception has now become more widely available and used, although a sizable percentage of women still do not use it. Therefore, this study aims to assess the factors associated with the discontinuation of the LARC method among female users of health facilities in Shashemene town in Oromia, Ethiopia. A facility-based cross-sectional study was conducted in Shashemene town involving 410 study participants from nine facilities. The study participants were selected by using a systematic sampling method. The data were collected by using structured interviewer-administered questionnaires, entered into EpiData version 4.6.0.2, and exported to SPSS version 25 for analysis. Bivariate and multivariable logistic regressions were used to examine the association between independent variables and LARC discontinuation. The results were presented using the odds ratio at 95% CI. p < 0.05 was used to indicate statistical significance. The overall prevalence of women who discontinued the LARC method before the due date was 57.2%. Having an occupation as a housewife, desire for pregnancy, unwarned side effects, effectiveness, and dissatisfaction with the service provided were the factors positively associated with the discontinuation of the contraception. The prevalence of the discontinuation of LARCs was high. Pre-insertion, effective counseling about the benefits, follow-up care, management of side effects, and client reassurance are recommended.

Assessing the Factors That Affect the Use of Modern Contraceptive Methods Among Youth and Adolescents in Traditional Authority Chimwala, Mangochi District

Assessing the Factors That Affect the Use of Modern Contraceptive Methods Among Youth and Adolescents in Traditional Authority Chimwala, Mangochi District

Multidimensional Analysis of Adolescent Fertility in Latin America: Trends and Determinants

Adolescent pregnancy in Latin America constitutes a complex issue with significant consequences. High pregnancy rates among individuals under 20 years old impact education, personal development, and future opportunities. It is imperative to pay closer attention to sexual education, access to contraceptive methods, and reproductive health services to prevent unintended pregnancies and ensure the well-being of both adolescents and their children. The study aimed to elucidate the determinants influencing the adolescent fertility rate, thus providing an academic contribution for the formulation of public policies in Latin America. The period covered was 1990-2019, and the analyzed data were sourced from the World Population Prospects 2019 report. The main findings indicate that the adolescent pregnancy rate is alarming, attributed to the absence of effective public policies for control and prevention in response to this phenomenon. Received: 10 February 2024 / Accepted: 27 April 2024 / Published: 5 May 2024

Confidence in adolescent contraceptive counseling among residents and fellows training at the University of Texas Southwestern in Dallas, Texas

ObjectivesEvaluate trainees’ perceptions of past training and confidence in counseling about five contraceptive methods. Study DesignTrainees completed an online survey in 2020. Logistic regressions evaluated the relationship between participant characteristics and confidence. ResultsAmong 227 respondents (63% response rate), pediatric trainees reported the least confidence in counseling across each contraceptive method. Past training and confidence were associated. ConclusionsGaps in training should be addressed to improve confidence in contraceptive counseling among pediatricians in reproductively restricted states.

Knowledge Regarding Contraception and Previous Practices of Contraception Among Antenatal Women

Introduction: Contraceptive methods or devices are used to prevent pregnancy. Contraception enables women to realize their human rights and to choose whether or not to have children, as well as helps people achieve their desired family size. Currently, short-term family planning methods are available at levels of the health sector, but long-term methods are available at all levels. Objectives: To assess the knowledge regarding contraception and previous practices of contraception among antenatal women at term pregnancy attending gynaecology OPD. Methodology: An exploratory cross-sectional study was conducted. The total enumeration sampling technique was used, and 120 study participants were enrolled for the study. Data was collected by interviewing participants as per an interview schedule. Results: The study findings showed that a majority (76.6%) of the antenatal women had poor knowledge regarding contraception and 23.3% antenatal women had average knowledge. A majority (81.07%) of participants had previously practiced contraception. The most commonly used contraceptives were condoms and the calendar method. Conclusion: In the present study, more than half of the participants (antenatal women) had poor knowledge regarding contraception. It indicates the need for awareness regarding contraception and the appropriate use of contraceptive methods when required.

Association between knowledge and use of contraceptive among women of reproductive age in sub-Saharan Africa.

The use of contraceptives has been considered relevant in reducing unintended pregnancies in sub-Saharan Africa (SSA). However, despite evidence of knowledge of contraceptives, their use remains low in SSA. This study examined the association between knowledge of contraceptive methods and the use of contraceptives in SSA. Data for the study were extracted from the Demographic and Health Surveys of 21countries in SSA spanning from 2015 to 2021. A weighted sample of 200,498 sexually active women of reproductive age were included in the final analysis. We presented the results on the utilization of contraceptives using percentages with their respective 95% confidence intervals (CI). We examined the association between knowledge of contraceptive methods and the use of contraceptives using multilevel binary logistic regression analysis. Overall, 24.32% (95% CI: 24.15-24.50) of women in SSA used contraceptives. Chad had the lowest prevalence of contraceptive use (5.07%) while Zimbabwe had the highest prevalence (66.81%). The odds of using any method of contraception were significantly higher for women with medium [Adjusted odds ratio (AOR) = 1.89; 95% CI = 1.80-1.98] and high [AOR = 2.22; 95% CI = 2.10-2.33] knowledge of contraceptive methods compared to those with low knowledge, after adjusting for all covariates. Our study has shown that the use of contraceptives among women in SSA is low. Women's knowledge of any contraception method increases their likelihood of using contraceptives in SSA. To improve contraceptive use in SSA, targeted interventions and programmes should increase awareness creation and sensitization, which can improve women's knowledge on methods of contraception. Also, programmes implemented to address the low uptake of contraceptives should consider the factors identified in this study. In addition, specific subregional strategies could be implemented to narrow the subregional disparities.

Current strategies using 3D organoids to establish in vitro maternal-embryonic interaction.

The creation of robust maternal-embryonic interactions and implantation models is important for comprehending the early stages of embryonic development and reproductive disorders. Traditional two-dimensional (2D) cell culture systems often fail to accurately mimic the highly complex in vivo conditions. The employment of three-dimensional (3D) organoids has emerged as a promising strategy to overcome these limitations in recent years. The advancements in the field of organoid technology have opened new avenues for studying the physiology and diseases affecting female reproductive tract. This review summarizes the current strategies and advancements in the field of 3D organoids to establish maternal-embryonic interaction and implantation models for use in research and personalized medicine in assisted reproductive technology. The concepts of endometrial organoids, menstrual blood flow organoids, placental trophoblast organoids, stem cell-derived blastoids, and in vitro-generated embryo models are discussed in detail. We show the incorportaion of organoid systems and microfluidic technology to enhance tissue performance and precise management of the cellular surroundings. This review provides insights into the future direction of modeling maternal-embryonic interaction research and its combination with other powerful technologies to interfere with this dialogue either by promoting or hindering it for improving fertility or methods for contraception, respectively. The merging of organoid systems with microfluidics facilitates the creation of sophisticated and functional organoid models, enhancing insights into organ development, disease mechanisms, and personalized medical investigations.

Sterilization Surgery Trends in Texas After Passage of the Texas Heartbeat Act [ID 2683648

INTRODUCTION: On September 1, 2021, abortion became illegal in Texas once electric embryonic cardiac activity can be detected. Before that, elective abortions were allowed up to 20 weeks postfertilization. In order to primarily avoid unwanted pregnancy, a trend for younger women to seek a definite contraception method has been observed; however, this has not been studied yet. The aim of this study was to compare the characteristics of women requesting surgical sterilization before and after the Texas Heartbeat Act went into effect. METHODS: This is a retrospective study including all women who underwent bilateral salpingectomy for surgical sterilization between May 2020 and November 2022. Women who underwent surgery 15 months before the new laws (controls) were compared to women who underwent surgery 15 months after the change (study group). Demographic, clinical characteristics, operative, and postoperative data were collected from women's medical files. RESULTS: Two hundred five women met inclusion criteria, of them 131 (64%) in the study group and 74 (36) controls. The rate of women with managed care insurance was significantly higher in the study population (P=.04). Median age was similar between the groups (P=.98). Parity was significantly higher in the controls (P=.004); however, the rate of nulliparous women more than doubled in the study population (37 [28%] versus 8 [11%]; P=.004). Surgery as first contraception method was reported in 63 (48%) and 41 (19%) of the women in the study and control groups, respectively (P=.58). Complication rate was found higher for the study group, but the difference did not reach significance [4 (3.1%) versus 0 (0); P=.13]. CONCLUSION: Since the passage of the Texas Heartbeat Act, more women with managed care insurance were undergoing surgical sterilization. Although the mean age to undergo the surgery did not change compared to the period before the change in the law, the rate of nulliparous women preferring this method for contraception significantly increased.

Assessing Pregnant Patients' Postpartum Contraceptive Plans After the SCOTUS Dobbs Decision in a Highly Restrictive State [ID 2683439

INTRODUCTION: The June 2022 SCOTUS Dobbs decision removed federal protection to abortion access. In August 2022, a Tennessee trigger law made ending a pregnancy for any reason a felony. We hypothesized that this change would result in more pregnant patients desiring highly effective (long-acting or permanent) contraceptive methods after delivery. METHODS: This retrospective cohort analysis used electronic health records to capture demographic and pregnancy data for pregnant patients admitted for delivery in one East Tennessee hospital. Documented contraceptive plans chosen during pregnancy were categorized as highly effective (long acting or permanent) or moderate/least effective. Data were extracted from July 2019 to April 2020 (baseline) and compared to July 2022 to April 2023 (post-Dobbs). Chi-squared tests and binary logistic regression were conducted in SPSS. RESULTS: One-half (50.6%) of 7,489 records analyzed were post-Dobbs; 90.4% had a documented contraception plan upon hospital admission. Record of choosing a highly effective contraception plan during pregnancy decreased significantly baseline to post-Dobbs (47.2% to 39.6%; P&lt;.001). Logistic regression was used to further analyze the relationship between the Dobbs decision and highly effective contraception plan desired postpartum. Patients who delivered after the Dobbs decision had lower odds (adjusted odds ratio 0.726; 95% CI [0.652, 0.809]; P&lt;.001) of having highly effective contraception plans after controlling for age, number of living children, race/ethnicity, and insurance. CONCLUSION: A lower percentage of patients from the post-Dobbs cohort desired highly effective contraception after delivery. Further investigation should explore these surprising results. Regardless, patients should participate in patient-centered contraceptive counseling during prenatal care to make informed decisions after delivery.

Correlation of Medical Specialty With Malpositioned Intrauterine Devices [ID 2683518

INTRODUCTION: Intrauterine devices (IUDs) are an effective method of long-acting reversible contraception (LARC) and essential for preventing unintended pregnancies, as well as controlling abnormal uterine bleeding (AUB). Intrauterine devices are placed by both obstetrician−gynecologists and primary care providers. As an academic institution, our objective was to determine if training specialty of inserting provider correlated with the rate of malpositioned IUDs. METHODS: All ultrasounds from 2017 to 2020 in which an IUD was documented at SIU School of Medicine Department of Obstetrics and Gynecology, an American Institute of Ultrasound Medicine-certified center, were reviewed (IRB# 21-834). Association between specialty of inserting provider and malposition rate was assessed using chi-squared test. RESULTS: A total of 602 ultrasound reports documenting an IUD were reviewed; 109 malpositioned IUDs were identified (18.1%). Body mass index, age, and gravidity/parity were not significantly different in participants with malpositioned IUDs from those with a properly placed IUD. Indications for ultrasound included pelvic pain, bleeding, and lost strings. Intrauterine devices placed by primary care providers were malpositioned at a significantly higher rate than those placed by obstetrician−gynecologists, 30.0% versus 17.3%, respectively (P=.043). Obstetrician−gynecologists placed 1,961 IUDs and primary care providers placed 276 IUDs between 2017 and 2020. CONCLUSION: Intrauterine devices are a safe and reliable choice for LARC to prevent unwanted pregnancies and to control AUB. Training providers on proper techniques for IUD insertion is imperative for good clinical practice and patient satisfaction. Primary care providers are often seen for contraception management; therefore, the significantly higher malpositioned rate indicates the need to implement an enhanced simulation/education curriculum for IUD insertion.

Public Perspectives on the Inclusion of Pregnant People in Clinical Trials [ID 2683498

INTRODUCTION: Pregnant people remain underrepresented in clinical trials despite extensive efforts to increase participation. The public’s perception about including pregnant people in research is limited, and no publications to date specifically include self-identified males. This research aims to elucidate the attitudes of reproductive-aged people in the United States regarding the inclusion of pregnant individuals in clinical trials. METHODS: An IRB-approved survey including five Likert-scale questions concerning the inclusion of pregnant patients in research was distributed via Facebook Marketing. Self-reported gender, race, ethnicity, education level, political affiliation, religion, relationship status, and contraceptive use and method were analyzed in bivariate analyses. Variables significant in the bivariate analyses were included in multivariable logistic regression models. RESULTS: Among 743 respondents, 405 (54.6%) agreed that pregnant people should be excluded from clinical trials and 392 (52.8%) agreed that the risks of including pregnant people in clinical trials outweigh the benefits. Females had lower odds of agreement (odds ratio [OR] 0.46 [95% CI, 0.33–0.65] and 0.39 [95% CI, 0.28–0.54], respectively). Most respondents (74.2%) agreed that pregnant people should obtain partner consent prior to participation; notably, males had 3.9 times greater odds of agreement (95% CI: 2.51–6.10). Paradoxically, 504 people (67.9%) agreed that including pregnant people in research is important for providing evidence-based medicine. CONCLUSION: Most participants agreed with excluding pregnant people from clinical research; however, self-identifying females were more likely than males to value the safe inclusion of pregnant people in clinical research to advance evidence-based obstetrical care. This juxtaposition highlights an important challenge to achieving equitable inclusion of pregnant people in clinical research and the importance of public perception in improving maternal and child health outcomes.

Experience of using drospirenone/ethinyl estradiol combination in women of reproductive age

Introduction. A woman’s unwillingness to enter pregnancy due to social and somatic factors is associated with a high risk of its termination and concomitant complications. A personalized selection of a method of contraception is necessary, which best meets the needs of a woman, including in achieving non-contraceptive effects.Aim. To evaluate the effectiveness, safety and compliance indicators when using a combined drug (3 mg of drospirenone + 20 mcg of ethinyl estradiol) in women in the early and mature reproductive period.Materials and methods. A study involving 68 women (polycystic ovary syndrome (PCOS), n = 31, adenomyosis, n = 20, uterine fibroids, n = 7, a combination of 2 or more diagnoses) was conducted on the basis of the Scientific polyclinic Department of the V.I. Kulakov National Research Medical Center of the Ministry of Health of the Russian Federation) of reproductive age (18–34 years) who took a combined contraceptive drug for 6 months or more. The control of the results was carried out on the basis of monitoring in the form of a survey.Results. The average time of use of the drug was 9 (Q₁–Q₃: 8–11) months. After 3 and 6 months, 77.8% (21/27) and 100% of the observed patients, respectively, noted a decrease in the severity of PMS symptoms. 91.7% (n = 11/12) of patients noted a subjective decrease in the severity of acne and/or hirsutism after 6 months. 91.3% (n = 21/23) of women with copious painful menstruation noted normalization of the bleeding profile (volume of menstrual blood loss). 95.6% (65 patients out of 68) noted 100% compliance in the use of the drug.Conclusions. The drug Dimia has a favorable profile of clinical and pharmacological safety and efficacy, along with the complete reversibility of contraceptive action when actualizing the issue of the realization of reproductive function. The advantages of the drug are to achieve well-studied non-contraceptive effects, in which patients with PCOS, internal endometriosis and uterine fibroids are interested, in the form of relieving manifestations of PMS and reducing the severity of dysmenorrhea, as well as cosmetic skin imperfections (acne-type rashes, hirsutism). Thus, the drug can be recommended to women of reproductive age as a reliable contraceptive, as well as to achieve non-contraceptive effects.

Contraceptive behavior of women in India after induced abortion.

Putting an end to the silent pandemic of unsafe abortion is a major public health concern globally. Adoption of post-abortion contraception is documented as a significant contributor to reduce the number of unintended pregnancies and number of induced abortions. This study aimed at investigating the post abortion contraceptive behavior of Indian women exploring the determinants of post-abortion contraceptive uptake. Retrospective calendar data for 6,862 women aged 15-49 years from fifth round of National Family Health Survey (2019-2021) was used for the study. Multinomial logistic regression method was used to model the determinant factors to post-abortion contraceptive uptake. 72.6% women reported adopting no method of contraception after the abortion procedure. A total of 27.4% women adopted some method of contraception after abortion. 14% women preferred adopting short term modern methods. Women in early reproductive age group which is the most vulnerable group in experiencing unintended pregnancies are less likely to adopt any contraceptive method after abortion. Uptake of post abortion contraception is quite low in India. Effort should be taken in the direction of bringing awareness through provision of targeted contraceptive counselling after abortion.

Contraception in Medically Complex Adolescents and Young Adults.

Contraception is a significant part of comprehensive sexual and reproductive health (SRH) care for adolescents and young adults (AYA). While providers may assume that AYA with chronic illness are not sexually active, studies have shown that there are no differences in their sexual practices compared to their counterparts without an illness. This assumption may result in less SRH screening, preventative services, and counseling by providers resulting in decreased basic sexual knowledge, increased risk of unplanned pregnancy, and other health disparities. Sexually active AYA with medical complexity are particularly in need of contraception for a variety of reasons. A better understanding of the complexities around contraception counseling can help increase utilization rates, improve shared-decision making around family planning, and reduce the stigma around sexual health counseling in this population. We have included three sections. First, a general overview of contraception methods. Next, an overview of contraceptive methods currently available, their efficacy, and medical eligibility criteria for their use in AYA who have certain characteristics or medical conditions. Finally, cases adapted from real clinical scenarios to highlight specific recommendations for contraception in AYA women living HIV, autoimmune conditions, and those who have received a solid organ transplant. This information will help providers to consider the multiple factors that influence contraception decision-making (including clinical status, thrombosis risk, medication interactions, safety), and optimize care for AYA living with chronic illness.

Assessing the uterine bleeding profile in women using a subcutaneous contraceptive implant containing etonogestrel: Real-life clinical practice

Introduction. Pregnancy planning is one of the leading areas in the population reproductive health care, in particular preventing and reducing the number of abortions.Aim. To evaluate the uterine bleeding profile and other adverse events associated with the use of an etonogestrel subcutaneous contraceptive implant (Implanon NXT®). Materials and methods. We analysed medical records of female patients (n = 153) who used Implanon NXT® in the period from 2013 to 2023, records of adverse events, uterine bleeding, bleeding management techniques and reasons given by women for discontinuing the use of implants.Results. The median duration of uterine bleeding episodes ranged from 7 to 13 days within a three-year period of use of Implanon NXT®. During the first 3 months, the proportion of women with prolonged bleeding was higher as compared to all other observation periods and gradually decreased during the first year of use of the drug from 41.2 to 15.8%. 40 patients with complaints of unsatisfactory uterine bleeding patterns required adjustment of drug dosages; 14 women continued to use Implanon NXT® after adjustment of drug dosages and repeated visits. 17.0% (n = 26) of patients required early removal of the implant. Due to pregnancy planning, the implant was removed early in 13% (n = 20) of patients. The most common adverse events included functional ovarian cysts, mastalgia, increased appetite, decreased libido, dizziness, acne; most of them were transient and did not require any management, and were not considered the reason for implant removal.Conclusion. The number of uterine bleeding episodes in patients using the etonogestrel implant was comparable to the normal menstrual cycle. Some women had changes in the uterine bleeding patterns, such as amenorrhea, frequent and prolonged bleeding, which reduced the duration of use of this contraception method. At the same time, combined oral contraceptives were the most effective as compared to other drugs used in correction regimens.

Side Effects, Discontinuation, and Failure Rates of Copper T Intrauterine Contraceptive Device in Kano, Northern Nigeria

Abstract Context: Intrauterine contraceptive device is one of the long-term reversible contraceptives that has gained popularity over the years globally. It is a procedure that has complications which can be mild to severe and may lead to discontinuation of the method. Aims: To determine the complications, discontinuation and failure rate of IUCD in Murtala Muhammad Specialist Hospital, Kano. Study Design: Prospective cohort study. Methodology: This was a cohort study of women who had IUCD inserted at family planning clinic of Murtala Muhammad Specialist Hospital, between November 2018 and February 2019. Women were followed up for a period of 6 months to determine the complications, discontinuation, and failure rate within the period. Statistical Analysis: Microsoft Excel was used to obtain frequencies and percentages, and the data were represented using simple statistical tables. Data analysis was performed using SPSS Version 23.0. Results: Women in the age group of 30–39 years use IUCD more (64.29%) than other age group. Women of higher parity (5–9) constitute 60.71% of the clients. Complications were observed in 10 clients (17.86%). The most common complication was menorrhagia among 4 clients (7.14%): 2 clients (3.57%) developed abdominal pain and 2 (3.57%) had intermenstrual bleeding. The least complications were dyspareunia and hypomenorrhea observed in 1 client each (1.79%). Four clients opted for IUCD removal giving a discontinuation rate of 7.14%. Conclusion: Few of the clients have complications, and none become pregnant, with a low discontinuation rate indicating that IUCD is a safe and efficient contraceptive method.