Long-Acting Reversible Contraception

Baker, Courtney C.; Creinin, Mitchell D.

doi:10.1097/aog.0000000000004967

Cited by 15 publications

(25 citation statements)

References 130 publications

(150 reference statements)

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“…Various IUD inserters are available specific to related products, with diameters ranging from 3.8 to 4.8 mm 7 . A randomized trial of levonorgestrel IUDs with 3.8 and 4.8 mm diameter inserters found no difference in the proportion with severe pain or physicians reporting difficult insertions 8 …”

Section: Discussionmentioning

confidence: 99%

Feasibility study of a single‐handed inserter for levonorgestrel 52 mg intrauterine device placement

Eisenberg,

Schreiber,

Blumenthal

et al. 2023

Repro Female Child Health

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ObjectiveTo assess placement outcomes using a levonorgestrel 52 mg intrauterine device (IUD) inserter designed for single‐handed use.MethodsInvestigators enroled participants 18–45 years to have the IUD inserted using a redesigned inserter with removal 5–15 min after placement. Physicians and participants provided feedback on their insertion experience.ResultsSuccessful placement occurred in 48 of 50 (96.0%) enroled participants. Investigators rated insertion device loading “easy” in 49 (98.0%) and placement “easy” in 44 (88.0%) cases. Cramping pain was reported at insertion by 47 (94.0%) participants, mostly mild (32 [64.0%]) or moderate (11 [22.0%]).ConclusionThe single‐handed inserter is easy to use and results in high rates of insertion success.

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Section: Discussionmentioning

confidence: 99%

Feasibility study of a single‐handed inserter for levonorgestrel 52 mg intrauterine device placement

Eisenberg,

Schreiber,

Blumenthal

et al. 2023

Repro Female Child Health

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“…Provider counseling and health care system provision of contraception must take this into account. Moreover, LARC devices are not permanent but often need to be removed by a provider, and access to appointments for removal of devices must be equitable so as to ensure that all patients who desire return of fertility, or to switch to another form of contraception or no contraception, are able to do so within a reasonable time frame [6].…”

Section: Ethical Considerationsmentioning

confidence: 99%

“…Benefits to these devices include their high effectiveness, ease of use, and quick return to baseline fertility after removal [5]. For LARC methods, pregnancy rates range from 0.1% to 0.8% in the first year of typical use [6]. Compared to those who use no contraceptive method or short-acting contraceptive methods, people who use LARC are less likely to have short IPIs [7].…”

Section: Introductionmentioning

confidence: 99%

Interpregnancy Care and Access to Long-Acting Reversible Contraception

Wise

Urrutia

2023

North Carolina Medical Journal

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“…Long-acting reversible contraception (LARC) is the gold standard and first-line contraception choice for patients seeking to avoid pregnancy in the next 12 months [1][2][3]. Entities such as the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists (ACOG) assert that all eligible patients should be counseled on LARCs, as these methods remain the most effective method of preventing pregnancy [1]. LARCs include intrauterine devices (IUDs) and contraceptive implants.…”

Section: Introductionmentioning

confidence: 99%

Continuation Rates of the Etonogestrel Implant and Factors Associated With Early Discontinuation

Hines¹,

Wang²,

Walker³

et al. 2023

Cureus

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Background: The etonogestrel implant is generally considered an effective, three-year, long-acting reversible contraceptive device. Previous research, such as the landmark CHOICE study, has reported a oneyear continuation rate of 72% to 84%, however, in a real-world setting these rates may be significantly lower.Objective: To study etonogestrel implant continuation rates and factors associated with early discontinuation in a specific clinical setting.Study design: Single-center, retrospective cohort study of patients who received the etonogestrel implant between January 1, 2015, and December 31, 2017, at several practices at an academic community hospital network. Records were reviewed up to three years after implant insertion to determine continuation rates (one to three years), early discontinuation rates (≤12 months), and reasons for early discontinuation. A sample size calculation was performed to guide a subanalysis of side effects.Results: A total of 774 patients underwent etonogestrel insertion during the study period. The one-year continuation rate was lower than that of the CHOICE study (62% vs. 83%, P <0.001). A subanalysis (n=216) revealed that a majority (82%, n=177) of patients reported side effects. Side effects were more common in patients with early discontinuation compared with patients who continued use longer than one year (93% vs. 71%, P <0.001). The most common side effect, abnormal uterine bleeding, was not significantly associated with early discontinuation. A significant association (P=0.02) was found between early discontinuation and neurologic/psychiatric complaints.Conclusions: The one-year continuation rate of the etonogestrel implant in our population is significantly lower than the value reported by CHOICE. Implant side effects are common and significantly affect rates of discontinuation. Our data suggest there is an opportunity for education and counseling for individuals opting for this method of long-acting contraception.

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Long-Acting Reversible Contraception

Abstract: Our understanding of long-acting reversible contraceptives is evolving, with new evidence on duration of use, efficacy, and safety differences between products.

Cited by 15 publications

References 130 publications

Feasibility study of a single‐handed inserter for levonorgestrel 52 mg intrauterine device placement

Feasibility study of a single‐handed inserter for levonorgestrel 52 mg intrauterine device placement

Interpregnancy Care and Access to Long-Acting Reversible Contraception

Continuation Rates of the Etonogestrel Implant and Factors Associated With Early Discontinuation

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