Use of contraceptives in the rehabilitation of reproductive function in women with infertility after endosurgical intervention in the ovaries

Abstract

Objective: To evaluate the contraceptive efficacy and acceptability of a prolonged subcutaneous contraceptive implant containing 68 mg of etonogestrel (Implanon NXT®) in women of reproductive age. Design and Methods:This prospective study included 48 women aged 19 to 45 years (mean age 28.0 ± 1.7 years) seeking effective long-term contraception. Inclusion criteria were reproductive age, interest in reliable contraception, and absence of contraindications to progestin contraception. Exclusion criteria included contraindications to progestin hormonal contraception according to WHO medical eligibility criteria (2015), current or suspected pregnancy, use of hormonal contraception within the last three months, and unexplained uterine bleeding. Clinical, clinical-laboratory, instrumental, and statistical methods were employed. The follow-up period lasted one year. Results:No pregnancies were registered during the entire observation period. Complications during implant insertion were minimal, with hematoma observed in only 1 (2.1%) case. The most common side effects involved changes in vaginal bleeding patterns: amenorrhea in 11 (22.9%) women, rare spotting in 17 (35.4%), frequent bleeding in 10 (20.8%), and prolonged spotting in 10 (20.8%) by the end of the first year. Weight gain averaging 2 kg was reported in 2 (4.2%) women. A total of 5 (10.4%) participants discontinued use, primarily due to prolonged and frequent bleeding episodes. Conclusions: The subcutaneous hormonal implant Implanon NXT® is an effective and acceptable method of contraception. The most frequent adverse events were alterations in the frequency and duration of vaginal bleeding, which correlated with the length of contraceptive use. Acceptability may be improved by adequate patient counseling prior to implantation.