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Contraception. 2013 Mar;87(3):370-4. doi: 10.1016/j.contraception.2012.08.001. Epub 2012 Sep 7.

Association of body mass index with removal of etonogestrel subdermal implant.

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Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USA.



Bleeding irregularities represent the most common etonogestrel subdermal implant (ESI) removal indication.


ESI placements (n=304) from June 2007 to April 2011 were grouped by removal indications. Group characteristics were compared using one-way analysis of variance, Kruskal-Wallis and χ(2) test.


Of 304 insertions, 30.6% reported irregular bleeding. Removal indications included bleeding (Group 1, n=50), side effects (Group 2, n=17) and desired pregnancy/no need (Group 3, n=25). Group 4 kept (n=198) or reinserted (n=14) ESI. Median body mass index was lower for Group 1 compared to other groups (p=.012). Group 3 was older than Group 1 or 4 (p=.021), and more likely parous (p<.001) and postpartum (p=.001) than other groups. Lactational placement was more common in Group 3 than 4 (p<.001). Obese women were 2.6 times less likely to remove ESI for bleeding vs. normal-weight or overweight women (95% confidence interval, 1.2-5.7; p=.014).


After adjusting for age and parity, obese women were less likely to have ESI removal for bleeding.

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