Reports of Two Broken Nexplanon® Rods

Abstract

Damage to progestin containing contraceptive implants has been reported for Implanon® rods but there appear to be few reports of damage to Nexplanon® rods. This report describes 2 cases of Nex-planon® rod breakage in an 18-year-old female and a 25-year-old female. The literature regarding damaged progestin implants is reviewed. These reports often involve an alteration in menstrual bleeding pattern and patients frequently request removal of bent or broken implants. The overall incidence of rod breakage and impact of damaged implants on contraceptive efficacy is not clear. Evidence based guidelines to inform management of suspected damage to contraceptive implants would be helpful. In the meantime, a shared decision-making process offering removal and replacement of damaged implants would seem reasonable. (J Am Board Fam Med 2019;32:269 -271.)

Complications of Long-Acting Reversible Contraceptive Modalities

“…In vitro studies have suggested that a broken or bent implant may release more etonogestrel than an intact one, and case reports have described increased vaginal bleeding after broken implants. These women did not become pregnant, but data are limited on the changes in efficacy after a broken rod, and we suggest shared decision-making with the patient and Ob/gyn regarding removal of a broken implant 10,45 …”

“…These women did not become pregnant, but data are limited on the changes in efficacy after a broken rod, and we suggest shared decision-making with the patient and Ob/gyn regarding removal of a broken implant. 10,45 Pregnancy Pregnancy with implants is exceedingly rare. In a study of 7364 Nexplanon users, there were 12 pregnancies.…”

Multiple Research Methodologies Can Advance the Science of Family Medicine

“…A report of 2 such cases from the University of Arizona reviews the literature and offers clinical advice for other providers facing this dilemma. 14 Two well-done studies in this issue show that direct comparison of existing options often provides enlightening results. Tong et al 15 compare 2 tools that can be used to screen for prescription psychotherapeutic medication misuse.…”