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      Are there unmet needs in contraceptive counselling and choice? Findings of the European TANCO Study

      1 , 2 , 3 , 4
      The European Journal of Contraception & Reproductive Health Care
      Informa UK Limited

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          Contraceptive failure in the United States.

          This review provides an update of previous estimates of first-year probabilities of contraceptive failure for all methods of contraception available in the United States. Estimates are provided of probabilities of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct and consistent use). The difference between these two probabilities reveals the consequences of imperfect use; it depends both on how unforgiving of imperfect use a method is and on how hard it is to use that method perfectly. These revisions reflect new research on contraceptive failure both during perfect use and during typical use. Copyright © 2011 Elsevier Inc. All rights reserved.
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            The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception.

            To introduce and promote the use of long-acting reversible methods of contraception (LARC; intrauterine contraceptives and subdermal implant) by removing financial and knowledge barriers. The Contraceptive CHOICE Project is a prospective cohort study of 10,000 women 14-45 years who want to avoid pregnancy for at least 1 year and are initiating a new form of reversible contraception. Women screened for this study are read a script regarding long-acting reversible methods of contraception to increase awareness of these options. Participants choose their contraceptive method that is provided at no cost. We report the contraceptive choice and baseline characteristics of the first 2500 women enrolled August 2007 through December 2008. Sixty-seven percent of women enrolled (95% confidence interval, 65.3-69.0) chose long-acting methods. Fifty-six percent selected intrauterine contraception and 11% selected the subdermal implant. Once financial barriers were removed and long-acting reversible methods of contraception were introduced to all potential participants as a first-line contraceptive option, two-thirds chose long-acting reversible methods of contraception. Copyright (c) 2010 Mosby, Inc. All rights reserved.
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              Continuation and satisfaction of reversible contraception.

              To estimate 12-month satisfaction and continuation rates of intrauterine device (IUD) and implant users enrolled in the Contraceptive CHOICE Project and compare these measures with women using the oral contraceptive pills (OCPs). We analyzed 12-month data from the first 5,087 participants enrolled in a prospective cohort study of women in the St. Louis region offered contraception at no cost for 3 years. The primary purpose of CHOICE is to promote the use of long-acting reversible contraception (IUDs and implants) and to reduce unintended pregnancies in our region. This analysis includes those participants who received their baseline contraceptive method within 3 months of enrollment and who reached the 12-month follow-up telephone survey time point (n=4,167). Sixty-eight percent of our participants chose a long-acting reversible contraception method (45% levonorgestrel intrauterine system, 10% copper IUD, and 13% subdermal implant), 23% chose combined hormonal methods (11% OCPs, 10% vaginal ring, and 2% transdermal patch), and 8% chose depot medroxyprogesterone acetate. Long-acting reversible contraception users had higher 12-month continuation rates (86%) than OCP users (55%). The two IUDs had the highest 12-month continuation rates: levonorgestrel intrauterine system (88%) and copper IUD (84%). Women using the implant also had very high rates of continuation at 1 year (83%). Satisfaction mirrored continuation: more than 80% of users were satisfied with the IUD compared with 54% satisfied with OCPs. IUDs and the subdermal implant have the highest rates of satisfaction and 12-month continuation. Given that long-acting reversible contraception methods have the highest contraceptive efficacy, these methods should be the first-line contraceptive methods offered to patients.
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                Author and article information

                Journal
                The European Journal of Contraception & Reproductive Health Care
                The European Journal of Contraception & Reproductive Health Care
                Informa UK Limited
                1362-5187
                1473-0782
                May 31 2018
                May 04 2018
                May 22 2018
                May 04 2018
                : 23
                : 3
                : 183-193
                Affiliations
                [1 ] Department of Reproductive Endocrinology, University Hospital, Zurich, Switzerland;
                [2 ] Bayer, Basel, Switzerland;
                [3 ] Bayer, Leverkusen, Germany;
                [4 ] Department of Obstetrics/Gynecology, University Hospital, Basel, Switzerland
                Article
                10.1080/13625187.2018.1465546
                29785864
                de4fd212-c21d-4a96-b7de-434954c42d94
                © 2018
                History

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