Observational studyObstetrics and gynecology2015
Use of the etonogestrel implant and levonorgestrel intrauterine device beyond the U.S. Food and Drug Administration-approved duration.
Observational study in Obstetrics and gynecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Effectiveness of the etonogestrel subdermal implant in users with overweight and obesity: a systematic literature review.BMJ sexual & reproductive health · 2025Pooled it
- Extended duration of use of long-acting reversible contraceptives: Systematic review.Canadian family physician Medecin de famille canadien · 2025Pooled it
- Progestogen-releasing intrauterine systems for heavy menstrual bleeding.The Cochrane database of systematic reviews · 2020Pooled it
- Contraception for HIV-Infected Adolescents.Pediatrics · 2016Guideline
- Trial
- Extended use up to 5 years of the etonogestrel-releasing subdermal contraceptive implant: comparison to levonorgestrel-releasing subdermal implant.Human reproduction (Oxford, England) · 2016Trial
- Compounded hormonal pellets: a critical review of current evidence and risks.Revista da Associacao Medica Brasileira (1992) · 2025Article
- Offering extended use of the contraceptive implant via an implementation science framework: a qualitative study of clinicians' perceived barriers and facilitators.BMC health services research · 2024Article
- An exploratory study on the possible association of serum etonogestrel concentrations with mood concerns and symptoms among contraceptive implant users.Contraception · 2024Article
- Society of Family Planning Clinical Recommendations: Contraceptive Care in the Context of Pandemic Response.Contraception · 2022Article
- [Contraception in adolescents with obesity and diabetes mellitus].Problemy endokrinologii · 2022Article
- Safety and Benefits of Contraceptives Implants: A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2021Review
- Pharmacokinetics, metabolism and serum concentrations of progestins used in contraception.Pharmacology & therapeutics · 2021Review
- Prioritisation of outpatient appointments and elective surgery in gynaecology.Best practice & research. Clinical obstetrics & gynaecology · 2021Review
- Doing Things Differently: What It Would Take to Ensure Continued Access to Contraception During COVID-19.Global health, science and practice · 2020Article
- Contraception for AdolescentsJournal of clinical research in pediatric endocrinology · 2020Article
- Quality of Long-acting Reversible Contraception Provision in Lomé, Togo.Open access journal of contraception · 2020Article
- Article
- The use of long-acting reversible contraceptives in Latin America and the Caribbean: current landscape and recommendations.Human reproduction open · 2018Article
- Postpartum intrauterine device placement: a patient-friendly option.Contraception and reproductive medicine · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveTo evaluate the effectiveness of the contraceptive implant and the 52-mg hormonal intrauterine device (IUD) in women using the method beyond the current U.S. Food and Drug Administration (FDA)-approved duration of 3 and 5 years, respectively.
methodsWomen willing to continue using their implant or 52-mg levonorgestrel IUD beyond the FDA-approved duration were followed prospectively for contraceptive effectiveness. Unintended pregnancy rate per 100 women-years was calculated. Implant users are offered periodic venipuncture for analysis of serum etonogestrel levels. The Kruskal-Wallis test was used to compare the etonogestrel levels across body mass index (BMI) groups.
resultsImplant users (n=237) have contributed 229.4 women-years of follow-up, with 123 using the etonogestrel implant for 4 years and 34 using it for 5 years. Zero pregnancies have been documented, for a failure rate of 0 (one-sided 97.5% confidence interval [CI] 0-1.61) per 100 women-years. Among 263 levonorgestrel IUD users, 197.7 women-years of follow-up have been completed. One pregnancy was confirmed, for a failure rate of 0.51 (95% CI 0.01-2.82) per 100 women-years. Among implant users with serum etonogestrel results, the median and range of etonogestrel level at 3 years of use was 188.8 pg/mL (range 63.8-802.6 pg/mL) and 177.0 pg/mL (67.9-470.5 pg/mL) at 4 years of use. Etonogestrel levels did not differ by BMI at either time point (3 years: P=.79; 4 years: P=.47).
conclusionPreliminary findings indicate the contraceptive implant and 52-mg hormonal IUD continue to be highly effective for an additional year beyond the FDA-approved 3 and 5 years. Serum etonogestrel levels indicate the implant contains adequate hormone for ovulation suppression at the end of both 3 and 4 years of use. LEVEL OF EVIDENCE: II.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.