Three-year continuation of reversible contraception.

Area of Science:

• Reproductive Health
• Contraception Research
• Clinical Trials

Background:

• Continuation rates are crucial for evaluating contraceptive method effectiveness and patient satisfaction.
• Long-acting reversible contraceptives (LARC) are highly effective but require assessment of real-world continuation.
• Comparison with non-LARC methods is essential for informed contraceptive choice.

Purpose of the Study:

• To estimate the 3-year continuation rates of LARC methods.
• To compare LARC continuation rates with those of non-LARC contraceptive methods.

Main Methods:

• Prospective cohort study (Contraceptive CHOICE Project) of 9256 participants.
• Telephone surveys conducted at 3, 6, and every 6 months for 2-3 years.
• Cox proportional hazard model used to adjust for confounding factors and estimate discontinuation risk.

Main Results:

• Analyzed 4708 participants meeting inclusion criteria.
• Three-year continuation rates: Levonorgestrel IUD (69.8%), Copper IUD (69.7%), Implant (56.2%).
• Overall 3-year continuation: LARC users (67.2%) vs. non-LARC users (31.0%) (P < .001).
• Adjusted hazard ratio for discontinuation was 3.08 times higher for non-LARC users (95% CI, 2.80-3.39).

Conclusions:

• Three-year continuation rates for intrauterine devices approached 70%.
• LARC methods demonstrated significantly higher continuation rates than non-LARC methods.
• Findings support LARC methods as highly sustainable contraceptive options.