Experience with Norplant in Alexandria.

Norplant implants (6 levonorgestrel subdermal capsules each containing 36 mg of levonorgestrel) were inserted during the 1st 7 days of the menstrual cycle in the upper arm of 250 regularly menstruating women of proven fertility. To compare the performance of the Norplant system with that of an established long acting method 100 acceptors of TCu 380 Ag were recruited to serve as controls. Recruitment of cases started January 1981 and ended February 1982. The experience of the 1st year follow-up has indicated that the net cumulative 12 month pregnancy rate is 0.41 with a continuation rate of 91% for Norplant acceptors. The corresponding figures in the group of TCu 380 Ag were 1.04 and 83.27% respectively. Menstrual problems were the principal reason for termination of the use of Norplant accounting for approximately 1/2 of all the terminations. The net cumulative 12-month termination rate for this reason was 5.14. Statistically significant increases in body weight and decreases in both systolic and diastolic readings of blood pressure occurred among Norplant acceptors after 1 year of use compared with preinsertion values; IUD acceptors showed only significant increases in body weight. The low pregnancy rate and high continuation rate of the Norplant implant system together with the fact that the effective lifetime is 5 years show that this modality may have a place in family planning programs especially if longterm research indicates its total safety. (authors)