Commentary

In some eyes, Implanon is an abortifacient


 

“Everything you need to know about the contraceptive implant” by Philip D. Darney, MD, MSc

I find Dr. Darney’s article misleading when it comes to the “2 mechanisms” of action given for Implanon. Inhibition of ovulation and failure of sperm penetration through cervical mucus are discussed, and readers are assured that the device “lacks abortifacient properties.” This assertion contradicts both the physician package insert and the patient information published by Organon and available on its Web site at www.implanon.com. These resources clearly state that “alterations in the endometrium” are an additional mechanism of action, ie, that Implanon could cause failure of blastocyst implantation.

Although some organizations do not consider the loss of a preimplantation embryo to be an “abortion,” it is erroneous to think that every patient will believe so. Indeed, some may pause at the thought that their chosen method of birth control may be causing the loss of early embryos.

Patients and providers deserve to know these facts, and we should be forthcoming about disclosing them. For an excellent review of this subject, please see Larimore’s article, “Postfertilization effects of oral contraceptives and their relationship to informed consent” (Arch Fam Med. 2000;9:126–133).

Kyle Beiter, MD
Phoenix, Ariz

Recommended Reading

Cefazolin Found Still Effective For Antepartum Pyelonephritis
MDedge ObGyn
LMWH During Pregnancy Preserves BMD
MDedge ObGyn
Screening for Thrombophilia In Pregnancy Called Futile
MDedge ObGyn
MRSA Present in 2% of Women Entering L&D
MDedge ObGyn
Modern Methods Cut Postpreeclampsia Stillbirths
MDedge ObGyn
Teen Reactions To Pregnancy Vary by Age
MDedge ObGyn
Tenofovir Accumulates In Fetal Compartment
MDedge ObGyn
Few Web Sites Good Sources of Patient Info on Labor Analgesia
MDedge ObGyn
Misoprostol Use as Potent Induction Agent Grows : The drug's pharmacokinetics vary with the route of administration; sublingual onset of action is fastest.
MDedge ObGyn
Simultaneous Abortion Medications Match 24-Hour Dosing
MDedge ObGyn