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Discussion Of A Systematic English Language Literature Review Using Pubmed

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Discussion
A systematic English-language literature review using PubMed was conducted. Searches included “etonogestrel implant and pregnancy,” “etonogestrel implant failure,” “Implanon and pregnancy,” and “Nexplanon and pregnancy.” The literature revealed that pregnancy with concomitant use of Implanon and Nexplanon is extremely rare. A total of 4103 women-years, comprising over 53,000 treatment cycles, were included in the initial clinical trials during Implanon development. There were no reported pregnancies during these trials leading to the resulting Pearl Index of 0.0 (95% CI, 0.0-0.9) (4).

In 2004, a postmarketing case series in Australia looking at unintended pregnancies with Implanon was published. This study compiled over 200 unintended pregnancies while Implanon was in use that were reported to the Australian Adverse Drug Reactions Advisory Committee during the first three years of marketing in that country. After excluding 91 women for reasons including insufficient data and pregnancy prior to Implanon insertion, a total of 127 cases of Implanon failure resulting in pregnancy was observed. The authors of this study found that the most common reason for unintended pregnancy was failure to insert the implant (84 cases). Following this were incorrect timing of insertion (19 cases), product failure (13 cases), interaction with hepatic enzyme-inducing medications (8 cases), and expulsion of Implanon (3 cases). The failure rate for postmarketing use
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