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Transition from Norplant to Jadelle in a clinic with extensive experience providing contraceptive implants

      Abstract

      Objective

      The purpose of this study was to understand the transition process from providing Norplant, the six-capsule first contraceptive implant system, to providing Jadelle, the two-rod second-generation system, in a clinical setting with extensive experience providing Norplant implants.

      Materials and Methods

      Two hundred forty-nine women requesting contraceptive implants from the PROFAMILIA clinic (Santo Domingo, Dominican Republic) were provided with information regarding the differences and similarities between the two implant systems being studied, including the easier insertion and removal procedures and the possible shorter use life associated with Jadelle. A questionnaire evaluating their preference and the reason why they chose either system was provided. The health care providers' opinions about the two systems were also studied.

      Results

      Fifty-three percent of the women preferred Jadelle over Norplant. The main reason behind their preference for Jadelle was its reduced number of implants with easier insertion and removal and less visibility in the arm, whereas that for Norplant was greater familiarity. Providers overwhelmingly preferred Jadelle. A 1-h presentation was sufficient training for providers experienced with Norplant. None had any problem with the management of Jadelle.

      Conclusion

      The inclusion of Jadelle in a clinic with extensive experience with Norplant was easy and uneventful, but both methods should be available during a transition period of several months while confidence in the new method is being acquired by the community.

      Keywords

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      References

        • Robertson D.N.
        • Sivin I.
        • Nash H.A.
        • Braun J.
        • Dinh J.
        Release rates of levonorgestrel from silastic capsules, homogeneous rods and covered rods in humans.
        Contraception. 1983; 27: 483-495
        • Sivin I.
        • Campod��nico I.
        • Kiriwat O.
        • et al.
        The performance of levonorgestrel rod and Norplant contraceptive implants: a 5 year randomized study.
        Hum Reprod. 1998; 13: 3371-3378
        • Sivin I.
        • Mishell D.R.
        • Diaz S.
        • et al.
        Prolonged effectiveness of Norplant�� capsule implants: a 7-year study.
        Contraception. 2000; 6: 187-194
        • Sivin I.
        • Wan S.
        • Ranta S.
        • et al.
        Levonorgestrel concentrations during 7 years of continuous use of Jadelle contraceptive implants.
        Contraception. 2001; 64: 43-49
        • Population Council website
        • Alvarez F.
        • Fa��ndes A.
        • Brache V.
        Clinical performance of Norplant�� implants over time: a comparison of two cohorts.
        Stud Fam Plann. 1988; 19: 118-121