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Contraception: what's new?
Date: 23 Jan 2019
Author: Dr Zara Haider
The latest developments in birth control outlined by Dr Zara Haider, Consultant in SRH at Kingston Hospital NHS Trust in Surrey
Written by Dr Zara Haider and Kaye McIntosh
The future of contraception includes an intrauterine ball, a remote-controlled microchip and a body-friendly oestrogen. Women look set to have a far greater range of choices, Dr Haider told delegates at our Current Choices event.
A significant development, aimed at low income countries is Annovera, approved in August 2018 by the FDA. A combined hormonal contraceptive (CHC) in a soft, flexible ring made of silicone, it delivers serum levels of 15mcg ethinyl estradiol (EE) and 150mcg nesterone.
It is inserted for three weeks, removed for one, and used for 13 cycles. A Phase 3 study of more than 2,000 women at 27 sites in the USA, Latin America, Europe, and Australia found efficacy and safety similar to other CHCs, while there was no increased risk of vaginal infection and no need for refrigeration.
The first wirelessly-controlled drug delivery microchip has been developed in research backed by the Gates Foundation. It is ‘the size of a scrabble tile’, just 2cm by 2cm, and less than 1mm deep, said Dr Haider. It can be implanted subcutaneously into the buttock, abdomen or upper arm.
Pre-clinical testing started in 2016 and it is set to be available soon. It supplies 30mcg levonorgestrel daily, from a sealed array of micro-reservoirs, for up to 16 years. Activated by a key fob, it can be controlled remotely. However, the fob has to be held over the implant, to ensure the right patient is being targeted.
Another advance is the intrauterine ball a flexible, frameless device, introduced using a narrow, 3.2mm inserter.
Out of 40,000 insertions across Europe, only 1.6% have been expelled. There have been just 42 pregnancies, an efficacy rate of 99.89%.
Interim data from a study of 336 patients showed slightly less bleeding from the ball compared to a traditional IUD. Up to two years post-insertion there was significantly less pain, but the full data has not yet been released.
Dr Haider said that more data comparing the intrauterine ball with other established contraceptive methods is needed.