What are the chances of pregnancy on nexplanon

Table of Contents Show

Myth: Pregnant while using an implant
Myth: Getting an implant is painful and could cause infection
Myth: Health risks and side effects
Myth: Complications with method
Myth: Infertility and ectopic pregnancy
Myth: Who can use the method
Myth: Menstrual bleeding
Myth: Sexual pleasure

Implanon was first available in the UK in 1999

Nearly 600 women have become pregnant despite using a popular contraceptive implant, a health watchdog has said.

There have also been more than 1,600 reports of adverse reactions to the Implanon device, which is designed to prevent pregnancy for three years.

The NHS has been forced to pay compensation to several women because of the failures, Channel 4 News reported.

1.4 million women have used Implanon, according to the Department of Health.

The implant maker, MSD, said no contraceptive was 100% effective.

It added that unwanted pregnancies may occur if the implant was not correctly inserted, and said it had a failure rate of less than 1% if inserted correctly.

The Medicines and Healthcare Regulatory Agency said that since the launch of Implanon in the UK 11 years ago, 584 women using it had become pregnant, with 1,607 reports of adverse reactions.

According to the Department of Health around 1.4 million women have used Implanon since it was first licenced in 1999.

The implant is a small plastic rod which releases hormones into the bloodstream, and is inserted under the skin of a woman's arm by a nurse or doctor.

The MHRA said it had also received complaints from doctors and nurses about difficulties inserting the device.

Late last year Implanon was replaced with a device called Nexplanon, which is designed to be inserted more easily.

The MHRA says although the implant had been replaced, "the safety of Implanon remains under close review."

Nine of the 584 women who reported an unwanted pregnancy used the terms "device failure", "device dislocation", "device ineffective" and "device difficult to use" to describe their experience.

Others reported scarring and problems with removing the 40mm long implant.

A lawyer for some of the 14 women claiming for personal loss and damage said many had not realised the pre-loaded applicator had not released the implant.

Stephanie Prior, partner of Anthony Gold Solicitors, told Channel 4 News: "I have clients who fell pregnant as they were unaware that the Implanon device had not been inserted into their arm and they suffered psychological difficulties as a consequence of falling pregnant and later miscarrying or having to make the difficult decision to terminate the pregnancy."

The NHS has paid compensation to nine women who between them received £118,000.

In a statement, manufacturers MSD said: "The basis for successful use of Implanon is a correct and carefully performed subdermal insertion of the implant in accordance with the product instructions.

"If the implant is not inserted in accordance with the instructions and on the correct day, this may result in an unintended pregnancy. In addition, no contraceptive is 100% effective."

Correct insertion of the device could be an issue, according to the Faculty of Sexual and Reproductive Healthcare. Their vice-president, Dr Alyson Elliman said:

"With the older device, Implanon, there is a risk of non-insertion - when someone might think they have inserted it but in fact the implant is still sitting in the tube which then gets removed. But clinicians are also relying on women having accurate recall of their menstrual cycle, and whether they have already risked pregnancy during that cycle."

Ann Furedi, chief executive of the British Pregnancy Advisory Service, added: "Implants are an excellent and usually extremely reliable method of birth control. But all contraceptives have a failure rate, and although with implants this is tiny, women do need to be aware."

Advice from the British Pregnancy Advisory Service is that women should not panic, even if they have one of the old versions of Implanon. They said:

"As long as you can feel the device under your skin and you are within the three year time frame there is no reason to get it checked, and no reason to request the newer version. However if you cannot feel it, or if you are having any problems with it, do get it seen. An ultrasound or x-ray will quickly establish whether the device is there."

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This page was originally published in 2012 and has since been updated.

Contraceptive implants are thin, small (4cm), flexible rods which are implanted under the skin of the upper arm by a doctor or a nurse. They are 99% effective in preventing pregnancy.

The implant rods contain progestins which are steadily released into the woman’s bloodstream. Progestins are like the hormone progesterone, which is produced naturally within a woman’s body.

The continuous release of progestins stops a woman releasing an egg every month (ovulation), and thickens the mucus from the cervix (neck of the womb), making it difficult for sperm to pass through to the womb and reach an unfertilized egg.

Implants protect against pregnancy soon after as they have been inserted. Depending on the type of implant, they last between 3-5 years, but can be removed at any time. Fertility returns when the implant is removed.

Some women experience side effects form implants. It is common, but not harmful, to experience changes in menstrual bleeding patterns. Other possible side effects include abdominal pain, headaches, breast tenderness and acne. Side-effects often diminish over time, especially after the first few months to a year of use, but if you are concerned about side effects, you should go and talk to your provider.

When fitting the implant, a local anaesthetic is used to numb the area. It makes a small wound in the arm, which is closed with a dressing and does not need stitches.

Contraceptive implants do NOT protect against sexually transmitted infections (STIs, including HIV). To protect against STIs, male or female condoms need to be used.

Myth: Pregnant while using an implant

Some women who seek family planning believe that implants will interrupt an existing pregnancy.

Fact: A fetus will not be harmed by the insertion of an implant

Implants work primarily by thickening cervical mucus, which blocks sperm from meeting an egg, and by disrupting the menstrual cycle and preventing ovulation. Implants do not interrupt pregnancy. Good evidence shows that implants will not affect the pregnancy or harm the fetus if a woman is already pregnant when implants are inserted or becomes pregnant while using implants.

Myth: Getting an implant is painful and could cause infection

Some women who seek family planning believe that the insertion of implants requires surgery or that insertion is painful and causes infection. They may also have misconceptions about the removal of implants.

Fact: No stitches, no noticeable scar, and it can be removed at any time

Health professionals with specific training perform a minor surgical procedure to insert implants. The provider gives the patient an injection of local anesthetic under the skin of her arm to prevent pain while the implants are inserted. This injection may sting. The woman remains fully awake during the procedure. Insertion takes an average of 4 to 5 minutes for Norplant, 2.5 minutes for Jadelle, and 1.5 minutes for Implanon. Insertion can take more or less time, depending on the skill of the provider.

The incision is small and stitches are not required. In most cases, insertion does not leave a noticeable scar. Once inserted, the outline of the implants underneath the skin can be felt and sometimes seen. The woman may have bruising and feel pain or soreness for a few days afterward.

Infection at the insertion site can occur, but is uncommon. When infection occurs, it is usually within the first two months after insertion. In rare cases, implants may start to come out of the skin. When this occurs, it is usually due to improper insertion or infection.

A woman can have her implants removed at any time. Similar to insertion, implant removal is done by a specifically trained provider using local anesthesia and does not require stitches. Removal takes an average of 10 to 15 minutes for Norplant, 5 to 8 minutes for Jadelle, and 3 minutes for Implanon. Removal can take more or less time, depending on the skill of the provider. Difficulties with removal are rare if the implants were properly inserted and the provider is skilled.

Myth: Health risks and side effects

Some women who seek family planning do not want to use implants because they have misconceptions about implants causing illness or problems such as cancer, blindness, or birth defects.

Fact: Implants have several known health benefits

In addition to changes in menstrual bleeding, the most common side effects of implants are headaches, abdominal pain, and breast tenderness. These side effects are not an indication of illness and usually lessen or go away within the first year of use. Studies have not shown increased risk of cancer, blindness or birth defects with the use of implants.

They have been shown to greatly reduce the risk of ectopic pregnancy and protect against symptomatic pelvic inflammatory disease. Implants may also help protect against iron-deficiency anemia.

Myth: Complications with method

Some women who seek family planning believe that implants can cause complications in the arm in which they are inserted or that they can travel from the insertion site to other parts of the body.

Fact: Implants cannot travel to other parts of the body

They remain where they are inserted until they are removed. In rare cases, a rod may start to come out of the skin, usually during the first four months since insertion. This typically happens because the implants were not inserted well or because of an infection at the insertion site. If expulsion occurs, the woman should return to the clinic as soon as possible and use a back-up family planning method in the meantime. Providers can replace the rods.

Myth: Infertility and ectopic pregnancy

Some women who seek family planning believe that using implants will cause infertility, delay the return of fertility after the implants are removed, or cause ectopic pregnancies (pregnancy in which the fertilized egg implants in tissue outside the uterus).

Fact: Implant doesn't affect your fertility, and reduces the risk of ectopic pregnancy

Implants stop working once they are removed and their hormones do not remain in the woman’s body. Implant use does not affect a woman’s ability to become pregnant, although fertility decreases with a woman’s age. One major study found that women who have had their implants removed can become pregnant as quickly as women who have stopped using nonhormonal methods.

Implants substantially reduce the risk of ectopic pregnancy. In the United States, the rate of ectopic pregnancy among women who are not using a contraceptive method is 650 ectopic pregnancies per 100,000 women per year. The rate of ectopic pregnancy among women using implants is 6 ectopic pregnancies per 100,000 women per year.

Even in the very rare cases when implants fail and pregnancy occurs, the great majority of these pregnancies are not ectopic. Only 10 to 17 of every 100 pregnancies due to the failure of implants are ectopic.

Myth: Who can use the method

Some women who seek family planning believe that implants should not be used by women who are young or who have not had children.

Fact: Nearly all women can use implants safely and effectively

Implants are suitable for women of any age, regardless of whether they have had children or not. Implants do not make women infertile—fertility returns as soon as implants are removed. Breastfeeding women can use implants if at least six weeks have passed since they have given birth.

Implants may not be suitable for women who require a family planning method without hormones. For example, women who have or have had breast cancer and women with active, serious liver disease should choose an alternative method.

Myth: Menstrual bleeding

Some women who seek family planning incorrectly believe that using implants will cause harmful changes to menstrual bleeding.

Fact: Changes may occur, but generally they are not harmful

Changes in menstrual bleeding commonly occur with implant use, but some women do not experience any change. Typically, changes in bleeding patterns are more dramatic during the first year of use and either lessen or stop after the first year. Prolonged or heavy bleeding (lasting over eight days or generating twice as much blood as normal) due to implants generally is not harmful. Menstruation may also cease after one or two years of implant use, which is not harmful either—blood will not build up inside the woman.

Myth: Sexual pleasure

Some women who seek family planning believe that implants will reduce a woman’s libido or affect a couple’s sexual life in some way.

Fact: No evidence to suggest that implants can reduce a woman’s libido

There is no evidence to suggest that implants can reduce a woman’s libido. Some women using implants report negative changes in mood and sex drive, while some report improved mood and sex drive. Such changes could be caused by many other factors, so it is difficult to attribute them to implant use. A large majority of implant users do not report any change.