Effectiveness of prolonged IUD/implant for contraception (EPIC)

Awarded 2012
Complex Family Planning Fellowship Research
Colleen McNicholas, DO, MSCI
Washington University

Long-acting reversible contraceptive methods (LARC; intrauterine devices (IUDs) and the subdermal contraceptive implant) have numerous advantages over other forms of contraception; they are long lasting, convenient, reversible, forgettable, well-liked by users, have lower rates of discontinuation, and are cost effective. The levonorgestrel-releasing IUD (LNG-IUD) is FDA-approved for 5 years, and the etonogestrel (ENG) releasing implant is approved for 3 years of use. As the cost-effectiveness of IUDs and implants depend on the duration of use, it would be valuable to know if these highly effective contraceptive methods are effective for longer periods of time.
This is a prospective cohort study of LNG-IUD and ENG implant users, using their method beyond the current FDA-approved duration. Participants enrolled in this study are followed with telephone survey every 6 months for as much as 3 additional years of use. Additionally, ENG implant users are followed with periodic serum testing of ENG levels.
Data from the first two years of additional use (7 years for LNG-IUD and 5 years of ENG implant) have been published, support continued effectiveness during this extended duration, and has changed clinical practice. Publication of data from the remaining year of prolonged use is anticipated in 2020.