Indications for removal of etonogestrel implant within two years of use in Jos, Nigeria

Background: Implanon® is a new long-term and reversible sub-dermal contraceptive implant in Nigeria. It is a single rod containing 68mg of etonogestrel meant to offer contraception for three years and marketed by Organon.Objective: To determine the indications for removal of lmplanon® rods from clients within a two-year period.Design: A retrospective review of 30 consecutive lmplanon® removals within the study period.Setting: The fertility regulation unit of the department of obstetrics and gynaecology ofthe Jos University Teaching Hospital, North-Central Nigeria.Results: A total of 30 clients requested for and had their lmplanon® rods removed out of 669 insertions constituting 95.5% crude continuation rate in the second year. The clients were of mean age 31.4 ± 6.2 years, mean parity 2.9 ± 1.8 and mean number of living children 2.7 ± 1.6. There was an average weight gain of 1.9 kg. The most common indication for removal was menstrual disruption (33.3%). Desire for another pregnancyclosely followed (30.0%). Weight gain was another indication for discontinuation (13.3%). Two women were pregnant at insertion of the implant. There was one failure of the method with pregnancy as a result. Spousal disapproval was an indication for removal in two cases.Conclusion: Like all progestin-only contraceptive methods, menstrual disruption was the most common indication for removal of implants. Inadvertent insertion of implants with existing pregnancy is of concern and should be avoided as much as is possible. In doubtful cases at insertion, this insertion should be deferred or serum â-HCG should be assessed to exclude chemical pregnancy