Can a three months treatment with oral Desogestrel prior to insertion of the etonogestrel subdermal implant improve continuation rate at one year? A randomized trial

Abstract Objective: The aim of our study is to evaluate if daily oral 75µg of Desogestrel (DSG) for 3 months prior to the insertion of etonogestrel subdermal implant (ENG-IMPLANT) might help reduce its premature discontinuation.Results: A total of 66 women were randomized in the ENG-IMPLANT group (26) and in the DSG+ENG-IMPLANT group (40), respectively, in the Geneva University Hospitals and Basel University Hospital, from August 15th, 2016 through September 30th, 2019. In the DSG+ENG-IMPLANT group, patients were given a 3 months’ supply of 75µg of DSG before the insertion of the ENG-IMPLANT. All women were seen after 3 months for bleeding and satisfaction evaluation, and at 12 months post ENG-IMPLANT insertion. Higher levels of satisfaction at 12-months were found in the ENG-IMPLANT group compared to the DSG+ENG-IMPLANT group (8.5±1.7 vs. 6.6±2.9, p=0.012). There were no statistically significant differences regarding tolerance (7.8±2.5 vs 6.8±2.6, p=0.191) and contraceptive continuation (80% vs 72.4%, p=0.544) between groups. DSG prior to insertion of the ENG-IMPLANT did not improve its continuation rate neither its satisfaction at one year.Trial registration: NCT05174195. Retrospectively registered, the 30th December 2021.