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Comparative Study
. 2015 Jun;212(6):761.e1-8.
doi: 10.1016/j.ajog.2014.12.028. Epub 2014 Dec 30.

Complications and continuation rates associated with 2 types of long-acting contraception

Abbey B Berenson  1 , Alai Tan  2 , Jacqueline M Hirth  3
Affiliations
Comparative Study

Complications and continuation rates associated with 2 types of long-acting contraception

Abbey B Berenson et al. Am J Obstet Gynecol. 2015 Jun.

Abstract

Objective: We sought to compare complication and continuation rates of the levonorgestrel intrauterine system (LNG-IUS) with the subdermal etonogestrel (ENG) implant across the United States among girls and women 15-44 years of age.

Study design: A retrospective study of health insurance claims records from 2007 through 2011 identified a cohort of women who had LNG-IUS (n = 79,920) or ENG implants (n = 7374) inserted and had insurance coverage for 12 months postinsertion. Claims for complications were examined 12 months after insertion, or until removal of either device within each of 3 age groups.

Results: After its introduction in 2007, the frequency of ENG implants increased each year and almost a third of all insertions were in teenagers. However, among women ≤24 years old who had delivered an infant in the prior 8 weeks, a LNG-IUS was more likely to be inserted than an ENG implant (P < .05). The most frequent complications with both methods were related to abnormal menstruation, which was more likely to occur among ENG implant users. Overall, 83-88% of the entire sample used their chosen method for at least 12 months. The odds of continuation were similar for both methods among teenagers, but ENG implants were more likely to be removed prematurely among women 20-24 years old (odds ratio, 1.21; 95% confidence interval, 1.06-1.39) and 25-44 years old (odds ratio, 1.49; 95% confidence interval, 1.35-1.64).

Conclusion: Both of these long-acting contraceptive methods are well tolerated among women of all ages, and demonstrate high continuation rates.

Keywords: etonogestrel implant; intrauterine device; levonorgestrel intrauterine systems; long-acting reversible contraception.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1. Rate ratio of ENG implant insertion compared to LNG-IUS insertion in 2007–2011, by age group
Figure 1 descriptive sentence: Trends in the insertion rates of the ENG implant compared to LNG-IUS across time for 15 – 19 year olds, 20–24 year olds, and 25–44 year olds. Age formula image15–19 formula image20–24 formula image25–40
See this image and copyright information in PMC

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