New implants for family planning revealed

Posted: 30 October 2007

The next generation of contraceptive implants offer an extremely effective way to expand family planning choices for women and reduce the incidence of maternal mortality worldwide, according to a new report.

The new contraceptive implants are matchstick-sized plastic rods inserted just under the skin of a woman's upper arm. The new one-rod system Implanon, the two-rod system Jadelle, and the Sino-Implant (II) system, available in some countries, will replace Norplant, the original six-capsule contraceptive implant system that will be unavailable after 2008, according to the report from the Johns Hopkins Bloomberg School of Public Health report.

"Programs may want to add the new implants to their method mix, and programs currently offering Norplant should plan for a transition," according to co-authors Deepa Ramchandran and Ushma Upadhyay. The new implants offer the same advantages of the old system, but are easier and quicker to insert and remove and may be lower in price. Once inserted, implants require no action on the part of the client and are one of the most effective ways to prevent pregnancy. Five pregnancies in 10,000 users are expected during the first year of use, compared to 800 pregnancies out of 10,000 users with oral contraceptives.

Evidence suggests that demand for implants is high and that more women would choose implants if they could. Clients express satisfaction with its convenience and long-lasting effectiveness. Depending on the type of implants, they can be effective for three to five years. Fertility returns immediately upon removal. In addition, since implants contain no estrogen (a progestin hormone is released by the rods) they are suitable for breastfeeding women.

A chief concern with first-generation Norplant was its high cost of $27 per set. Of next generation implants, the cheapest is Sino-Implant (II), which has a wholesale price of about US $4.50. While the initial cost of implants is high, they can be cost-effective when used for several years.

Implants: The Next Generation is published in Population Reports by the INFO Project at the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs. The full-text version of this Population Reports issue is available at www.infoforhealth.org/pr/k7/k7.pdf