Findings, their interpretation and comparison to other studies
There have been numerous studies evaluating ENG-IMPLANT side effects but no trial, to our knowledge, who evaluate whether the practice of 3 months oral intake of DSG prior to ENG-IMPLANT insertion improves its continuation rate at-1-year.There was no statistically significant difference regarding overall satisfaction or method continuation when using DSG for 3 months prior to ENG-IMPLANT insertion. Women who tolerated well the DSG pill at 3 months (score > 5) did not seem to better tolerate the implant at 12 months, since the proportion of women reporting good to excellent tolerance at 12 months was lower compared to the ENG-IMPLANT group alone. This might suggest that using DSG in order to predict or improve the continuation rate at one year of ENG-IMPLANT is not a promising strategy.Analysis of side effects reported in both groups did not show a difference in average tolerance between the two groups at 3 and 12 months. However, women reported a higher level of satisfaction in the ENG-IMPLANT group than the DSG + ENG-IMPLANT group at 12 months (8.5 vs. 6.6, p = 0.012). The incidence of side effects with ENG-IMPLANT at 3 and 12 months are congruent with previous publications [The higher level of satisfaction at 12 months in the ENG-IMPLANT group compared with the DSG + ENG-IMPLANT group is probably related to the fact that the study was offered only to patients interested in a long-acting reversible contraception willing to accept the possibility of a randomisation to an initial 3 months period of pill intake. Patients’ self-determination when choosing a contraceptive method has shown to ultimately result in greater satisfaction and higher continuation rates [