In situ breakage of Implanon® — two cases of a rare occurrence

Abstract

Background: In situ breakage of Implanon® is a rare occurrence with unknown clinical significance. Authors report two different cases of broken Implanon® of women attended at our Family Planning Clinic. Discussion: In situ implants may spontaneously and asymptomatically break, although some uncertainty relies on whether that situation has a real impact on the contraceptive effectiveness or on bleeding patterns. Even more, it can be argued if, as a result of an occurrence of that nature, the implant shall or shall not be removed before the envisaged 3-year period of effectiveness. Conclusion: Currently, the clinical significance of implant breakage remains unknown. The decision to remove a broken or bent implant should be based on clinical judgements considering patients' wishes.

Retrospective Analysis of the Effectiveness and Reversibility of Long-Acting Contraception Etonogestrel (Implanon®) in Common Marmosets (Callithrix jacchus)

“…It is unknown if an implant remains as effective after a fracture in vivo. In humans, the fracture of an implant in situ is rare, and little is known about the clinical consequences [26][27][28][29][30]. There is no official recommendation by the manufacturers on when to remove a fractured ENG implant.…”

Long-Acting Reversible Contraception in the Pediatric Emergency Department

“…17,18,22 If the IUD is located in the intraperitoneal cavity, treatment for presumed pelvic inflammatory disease (PID) should be instituted. 27 These case reports do suggest that, in some cases, broken devices may lead to increased vaginal bleeding/spotting with improvement of symptoms after replacement of the device. The risk for expulsion is highest in the first 3 months after insertion and occurs in approximately 1 in 20 women, more commonly in nulliparous and younger women.…”

Reports of Two Broken Nexplanon® Rods

“…In this report, 1 of the rods was noted to have separated into 2 pieces without trauma, while the other rod broke into 2 pieces after the arm was grabbed forcefully. 3 This article cites unpublished data from Merck indicating that the release rate of etonogestrel may be altered by rod breakage. 3 This source stated that during development the implants were purposely damaged to determine the effect on hormone release.…”

“…3 This article cites unpublished data from Merck indicating that the release rate of etonogestrel may be altered by rod breakage. 3 This source stated that during development the implants were purposely damaged to determine the effect on hormone release. In response to the article from Elliman, Rekers 4 , a Merck employee, references the same unpublished Merck data of in vitro release of etonogestrel in damaged implants.…”