Extended Use of the Etonogestrel Implant and Levonorgestrel Intrauterine Device

Robert L. Barbieri, MD reviewing McNicholas C et al. Obstet Gynecol 2015 Mar.

Study suggests use of these contraceptive devices can be effectively extended 1 year beyond the FDA-approved interval.

The etonogestrel implant (Nexplanon) and levonorgestrel-releasing intrauterine device (LNG IUD; Mirena) excel in their effectiveness and user acceptance relative to other available reversible contraceptives. The FDA-approved duration of use is 3 years for the etonogestrel implant and 5 years for the LNG IUD. Researchers for the contraceptive CHOICE project assessed the outcomes associated with extending the use of these devices for as long as 2 years past the FDA's recommended limit.

Among 237 women who used the etonogestrel implant for a median of 12.5 months beyond the third year, no pregnancies occurred. Among the 263 women who used the LNG IUD for a median of 11.7 months past the fifth year, one pregnancy occurred (in a woman with a partially expelled IUD). The overall estimated failure rate per 100 women-years was 0.0 (one-sided 97.5% confidence interval, 0.0–1.6) for the etonogestrel implant and 0.5 (95% CI, 0.0–2.8) for the LNG IUD.

Citation(s):

McNicholas C et al. Use of the etonogestrel implant and levonorgestrel intrauterine device beyond the U.S. Food and Drug Administration-approved duration. Obstet Gynecol 2015 Mar; 125:599.