{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:26:16Z","timestamp":1780989976169,"version":"3.54.1"},"reference-count":41,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T00:00:00Z","timestamp":1729900800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Organon & Co., Jersey City, NJ, USA","award":["No grant\/award number"],"award-info":[{"award-number":["No grant\/award number"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2024,9,14]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The etonogestrel (ENG) subdermal implant is considered a well-tolerated and effective contraception option to avoid unintended pregnancies. However, it is unclear whether being affected by overweight or obesity diminishes the effectiveness of the implant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To systematically assess the published evidence on implant contraceptive effectiveness in women with overweight or obesity, and in women who underwent bariatric surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search strategy<\/jats:title>\n                    <jats:p>A systematic search of MEDLINE and Embase for publications reporting implant effectiveness since 2011.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection criteria<\/jats:title>\n                    <jats:p>Primary publications of randomised and non-randomised trials, observational studies and case reports were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data collection and analysis<\/jats:title>\n                    <jats:p>Two independent reviewers identified the Pearl Index, qualitative descriptions of contraceptive failure, implant exposure and potential bias, and assessed overall quality of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main results<\/jats:title>\n                    <jats:p>We found 12 publications meeting our criteria, consisting of nine observational studies and three case reports. Excluding case reports, the publications reported Pearl Indices from 0.0\/100\u2009women-years (WY) to 0.23\/100WY for women with overweight and obesity, respectively. No studies met the eligibility criteria for the post-bariatric surgery population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Observed implant effectiveness in women with overweight and obesity falls within the range of published data across all weight groups (0.0\u20131.4\/100 WY) and does not suggest a reduced effectiveness associated with higher body mass index. Large, well-controlled studies designed to specifically assess the effectiveness of the ENG implant with respect to user weight, particularly in women following bariatric surgery, are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjsrh-2024-202424","type":"journal-article","created":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T07:50:16Z","timestamp":1729929016000},"page":"299-307","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of the etonogestrel subdermal implant in users with overweight and obesity: a systematic literature review"],"prefix":"10.1136","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4921-3851","authenticated-orcid":false,"given":"Daisuke","family":"Goto","sequence":"first","affiliation":[{"name":"Organon & Co, Jersey City, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8761-4157","authenticated-orcid":false,"given":"John W","family":"Grunden","sequence":"additional","affiliation":[{"name":"Organon & Co, Jersey City, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7139-0427","authenticated-orcid":false,"given":"Moritz","family":"Klinghardt","sequence":"additional","affiliation":[{"name":"ZEG Berlin, Center for Epidemiology and Health Research GmbH, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0586-3019","authenticated-orcid":false,"given":"Vanessa Perez","family":"Patel","sequence":"additional","affiliation":[{"name":"Organon & Co, Jersey City, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5117-7242","authenticated-orcid":false,"given":"Sophia","family":"von Stockum","sequence":"additional","affiliation":[{"name":"ZEG Berlin, Center for Epidemiology and Health Research GmbH, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9236-1396","authenticated-orcid":false,"given":"Clare","family":"Barnett","sequence":"additional","affiliation":[{"name":"ZEG Berlin, Center for Epidemiology and Health Research GmbH, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7505-0684","authenticated-orcid":false,"given":"Johannes","family":"Bitzer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,10,26]]},"reference":[{"key":"2025112500351551000_51.4.299.1","unstructured":"United Nations Population Fund (UNFPA) . 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