Study Objective

To identify why adolescents with polycystic ovary syndrome (PCOS) chose the etonogestrel (ENG) contraceptive implant, to determine the 12-month continuation rate, and to characterize factors related to discontinuation.

Design, Setting, and Participants

Retrospective chart review of adolescents seen at a tertiary care children's hospital between July 1, 2008, and August 30, 2019, with PCOS diagnosis confirmed per National Institutes of Health criteria and ≥12-month ENG follow-up.

Interventions and Main Outcome Measures

Demographic characteristics, reasons for ENG insertion and removal, and information on other hormonal/contraceptive therapies were collected. Patients were categorized as ENG continuers (use ≥12 months) or discontinuers (removal at <12 months), and groups were compared.

Results

A total of 96 patients met inclusion criteria (age 17.7 ± 2.2 years, body mass index 34.8 ± 8 kg/m²). Reasons for ENG were documented in 74% (51% contraception, 32% ease of use, 15% other, 13% estrogen avoidance). In all, 27% had never been sexually active, and 67% had had prior sexual activity. Treatments prior to ENG placement included 74% combined hormonal contraception, 20% medroxyprogesterone acetate withdrawal, and 17% depot medroxyprogesterone. A total of 77% continued ENG at 12 months. The main reasons for discontinuation were bleeding (41%), concern about weight gain (23%), and mood changes (18%). No preimplantation characteristics were independently predictive of continuation, although 100% of patients with type 2 diabetes (n = 11) continued. Patients who sought additional care, including telephone calls (41% vs 12%, P = .006) and clinic visits (64% vs 20%, P < .001) were more likely to discontinue.

Conclusions

The ENG implant was well tolerated in adolescents with PCOS and similar to published 12-month continuation rates.

中文翻译：

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多囊卵巢综合症青少年中Etonogestrel植入的持续12个月。

研究目标

为了确定为什么患有多囊卵巢综合征（PCOS）的青少年选择了Etonogestrel（ENG）避孕植入物，确定12个月的持续率以及表征与停药有关的因素。

设计，设置和参与者

在2008年7月1日至2019年8月30日期间在三级儿童医院就诊的青少年的回顾性图表回顾，根据美国国立卫生研究院的标准和≥12个月的ENG随访确认了PCOS诊断。

干预措施和主要结果

收集了人口统计学特征，ENG插入和拔除的原因以及其他激素/避孕疗法的信息。将患者分为ENG延续者（使用≥12个月）或中断者（在<12个月时摘除），并进行分组比较。

结果

共有96名患者符合入选标准（年龄17.7±2.2岁，体重指数34.8±8 kg / m ²）。记录ENG原因的比例为74％（避孕率为51％，易用性为32％，其他为15％，避免了雌激素为13％）。总计，有27％的人从未进行过性活动，而67％的人以前没有过性活动。ENG放置前的治疗包括74％联合激素避孕，20％醋酸甲羟孕酮停药和17％甲羟孕酮库房。在12个月内，总共有77％的人继续使用ENG。停药的主要原因是出血（41％），担心体重增加（23％）和情绪变化（18％）。尽管100％的2型糖尿病患者（n = 11）仍在继续，但植入前的特征并不能独立预测是否继续。寻求额外护理的患者，包括电话（41％vs 12％，P  = .006）和门诊（64％vs 20％，P） <.001）更有可能终止。

结论

ENG植入物在PCOS青少年中耐受良好，与公布的12个月持续率相似。