Starting EVA After Nexplanon Removal
Yes, EVA can be started immediately after Nexplanon removal with no waiting period required. 1, 2
Timing Considerations for Starting EVA After Nexplanon Removal
- Nexplanon can be removed at any time during the menstrual cycle 2
- When switching from Nexplanon to another contraceptive method like EVA, the new method can be started immediately after removal 1, 2
- No waiting period is necessary between Nexplanon removal and starting a new contraceptive method 1
Backup Contraception Requirements
- If EVA is started immediately after Nexplanon removal, no additional backup contraception is needed 1
- Fertility returns rapidly after Nexplanon removal, so immediate initiation of a new method is recommended to maintain contraceptive protection 3, 4
- Studies show high rates of return to fertility following implant removal, with cumulative conception rates of up to 80.3% within one year after discontinuation 4
Procedure Considerations
- The removal procedure for Nexplanon is typically brief, with a mean removal time of 2 minutes 5
- The new contraceptive method (EVA) can be provided at the same visit as the Nexplanon removal 2
- For women who wish to continue using contraception, starting the new method immediately helps maintain continuous contraceptive coverage 1, 2
Clinical Recommendations for Providers
- No specific examinations or tests are needed before removal of Nexplanon in healthy women 2
- The Centers for Disease Control and Prevention recommends that when switching contraceptive methods, the new method can be started immediately if it is reasonably certain that the woman is not pregnant 1
- For optimal contraceptive coverage, healthcare providers should have the new method (EVA) available at the time of Nexplanon removal 1, 2
Common Pitfalls to Avoid
- Waiting unnecessarily between Nexplanon removal and starting EVA increases the risk of unintended pregnancy 6
- Failing to have the new method available at the time of removal may lead to gaps in contraceptive coverage 1
- Nexplanon is highly effective with a Pearl Index of 0.02 for during-use pregnancies, so maintaining similar contraceptive coverage with the new method is important 7