Contraceptive failure rates of etonogestrel subdermal implants in overweight and obese women.
OBJECTIVE
To estimate the contraceptive failure rates of the etonogestrel subdermal contraceptive implant in overweight and obese women and compare failure rates with women of normal weight and women using intrauterine devices (IUDs).


METHODS
The Contraceptive CHOICE Project is a large prospective cohort study designed to promote the use of long-acting reversible contraceptive methods to reduce unintended pregnancies in the St Louis region. Participants are provided reversible contraception of their choice at no cost. We collected baseline height and weight of each participant. During each survey, participants were asked about missed menses and possible pregnancies. Any participant who suspected a pregnancy was asked to come in for urine pregnancy testing. Analysis includes the first 8,445 participants enrolled in CHOICE of which 1,168 chose the implant and 4,200 chose the IUD. Student's t test, χ test, and Kaplan-Meier survival curves were used to perform statistical analyses to estimate failure rates in overweight and obese women using the implant and IUDs.


RESULTS
Of the women choosing the implant, 28% were overweight and 35% were obese. Of the women who chose an IUD, 27% were overweight and 35% were obese. The 3-year cumulative failure rates for implant and IUD users were less than one per 100 women-years and did not vary by body mass index.


CONCLUSIONS
We found no decrease in the effectiveness of the implant in overweight or obese women. The implant may be offered as a first-line contraceptive method to any woman seeking a reversible and reliable birth control method.
Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
Hanna
H
Xu
Jennifer A
JA
Wade
Jeffrey F
JF
Peipert
Qiuhong
Q
Zhao
Tessa
T
Madden
Gina M
GM
Secura
D000328:Adult; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D017135:Desogestrel / Q000008:administration & dosage*; D004343:Drug Implants / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D009765:Obesity; D050177:Overweight; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D055815:Young Adult
D003271:Contraceptive Agents, Female; D004343:Drug Implants; C044815:etonogestrel; D017135:Desogestrel