Evidence map›Paper›PMID 40069520›Full record

SynthesisArchives of gynecology and obstetrics2025

Subdermal implants vs. levonorgestrel intrauterine devices outcomes in reproductive-aged women: a systematic review and meta-analysis.

Juliana Almeida Oliveira, Gabriel Lage Neves, Matheus Eduardo Soares Pinhati, Flávia Ribeiro de Oliveira, Agnaldo Lopes da Silva Filho

Abstract readComparative StudyMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Archives of gynecology and obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Juliana Almeida OliveiraDepartment of Gynecology and Obstetrics, Federal University of Minas Gerais, Av.A Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG, 31270-901, Brazil. julianaoliveira_md@gmail.com.ORCID 0000-0002-4704-2318
Gabriel Lage NevesFaculty of Medical Sciences of Minas Gerais, Belo Horizonte, Brazil.ORCID 0000-0001-7060-1053
Matheus Eduardo Soares PinhatiFederal University of Minas Gerais, Belo Horizonte, Brazil.ORCID 0000-0003-4718-8840
Flávia Ribeiro de OliveiraDepartment of Gynecology and Obstetrics, Federal University of Minas Gerais, Av.A Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG, 31270-901, Brazil.ORCID 0000-0001-6282-7781
Agnaldo Lopes da Silva FilhoDepartment of Gynecology and Obstetrics, Federal University of Minas Gerais, Av.A Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG, 31270-901, Brazil.ORCID 0000-0002-8486-7861

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe aimed to conduct a systematic review and meta-analysis comparing the outcomes of subdermal implants and levonorgestrel intrauterine system (LNG-IUS) in reproductive-aged women.

methodsIn April 2024, we searched Pubmed, Embase and Cochrane trials using the search terms: "etonogestrel", "levonorgestrel" and "randomized controlled trials". We identified 2862 results comparing the LNG-IUS to subdermal implants. Randomized controlled trials (RCTs) were selected with no restrictions on language or year of publication.

resultsWe include six RCTs comprising 1503 patients. R Studio was used for statistical analysis. Subdermal implants were associated with a higher risk of dissatisfaction (OR 2.42; 95% CI 1.47-3.98), acne (OR 2.21; 95% CI 1.21-4.04), weight gain (OR 4.63; 95% CI 1.96-10.63), and device removal due to side effects (OR 2.02; 95% CI 1.20-3.41) compared to the LNG-IUS group. Subgroup analysis indicated that irregular bleeding may be influenced by gynecological conditions, and the risk of new ovarian cyst detection was lower in healthy women using subdermal implants. Norplant-2 was associated with an increased risk of irregular bleeding and a decreased risk of amenorrhea or infrequent bleeding. The leave-one-out analysis and heterogeneity were well distributed among studies for all evaluated outcomes.

conclusionsReproductive-aged women in use of subdermal implants experienced a higher rate of acne, weight gain, device removal due to side effects and dissatisfaction compared to those in use of LNG-IUS.

trial registrationPROSPERO ID: CRD42024516472.

Indexed as

Contraceptive Agents, FemaleDrug ImplantsIntrauterine Devices, MedicatedLevonorgestrelAdultDesogestrelFemaleHumansPatient SatisfactionRandomized Controlled Trials as TopicContraceptive Agents, FemaleDesogestrelDrug ImplantsLevonorgestrelAdenomyosisEndometriosisEtonogestrelImplanonLevonorgestrelMirena

Identifiers

PMID40069520
PMCPMC11985546

What OpenQuestion holds

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Registered trials

None linked

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.