J Med Assoc Thai 2019; 102 (6):657-62

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Three-Year Continuation Rate of Etonogestrel Subdermal Implant and Associated Factors
Assavapokee N , Wattanayingcharoenchai R Mail, Aimjirakul K

Objective: To determine continuation rate of etonogestrel subdermal implant (ESI) and to investigate the factors associated with continuation and reasons for early discontinuation.

Materials and Methods: Medical records of women who had ESI insertion at family planning clinic between January 1, 2014 and April 30, 2015 were reviewed. All implant clients who had a minimum follow-up period of three years or had implant removal at any time before three years of use were included in the study. Demographic data, information about contraceptive use, adverse hormonal effects including menstrual changes and weight changes were collected. Date of implant insertion and removal, and reasons for early implant removal were recorded.

Results: Of the 598 ESI clients, follow-up data was available for 431 cases (72.1%). Mean age of the ESI users was 25.1±8.9 years. About 43% of ESI users were teenagers. The continuation rates were 95.4%, 88.4%, and 83.1% in 1, 2, and 3 years, respectively. Women with age group less than 20 years and more than 40 years showed significant higher continuation rate than women in age group of 20 to 40 years (p<0.001). There was no association between BMI, education, obstetric history, previous contraceptive use, weight changes, menstrual changes, and ESI continuation. Unscheduled bleeding was the main reason for early implant removal. However, only 16.9% of ESI users having unscheduled bleeding discontinued implant use because of their bleeding problem.

Conclusion: Etonogestrel subdermal implant is highly effective and a cost-effective method of contraception. A high continuation rate of ESI through three years indicates the high acceptability of this methods in all age groups.

Keywords: Etonogestrel, Subdermal contraceptive implant, Long-acting reversible contraception, LARC, Continuation rate

Received 17 Dec 2018 | Revised 30 Apr 2019 | Accepted 2 May 2019

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