Methods of accurate localisation of non-palpable subdermal contraceptive implants.

©FSRH J Fam Plann Reprod Health Care 2008: 34(1) Introduction Implanon® (Organon International, Oss, The Netherlands) is a single rod, subdermal contraceptive implant system designed to release the progestogen etonogestrel at a near constant rate over 3 years.1,2 This system entered the market in The Netherlands in 1998, and soon after in many other countries in Europe and Asia. It is now marketed in over 35 countries3 and more than 3.3 million implants have now been sold worldwide.3 Many women have found Implanon to be a highly successful and convenient contraceptive, with more than one-third of users choosing a further implant at the end of the 3-year period.4 The success of the Implanon system has followed on from the extensive experience gained in many centres worldwide with the first subdermal contraceptive implants, namely the levonorgestrel-releasing implant system, Norplant® (developed by the Population Council, New York and Leiras, Finland). The clinical experience associated with this large number of insertions has inevitably been followed by extensive experience with implant removals. Many of these removals have occurred at around the end of the scheduled 3-year lifespan, but a large minority have occurred on patient request at an earlier date.5 In most countries, training for removals has been an integral part of the Implanon training programme that is recommended for doctors who intend to offer Implanon to their patients. These programmes have all strongly emphasised the need for precise attention to the directions for correct insertion in order to ensure straightforward removal at a later date. Since Implanon’s launch 8 years ago, clinical Methods of accurate localisation of non-palpable subdermal contraceptive implants