Contraceptive Effectiveness After Early Removal
The etonogestrel implant (Nexplanon) remains fully effective for contraception up until the moment it is physically removed from the arm, regardless of whether removal occurs before the 3-year expiration date. 1, 2
Immediate Loss of Contraceptive Protection
Contraceptive effectiveness ceases immediately upon implant removal, with rapid return to fertility. 2, 3 The key clinical points are:
- Fertility returns promptly after removal - pregnancy rates of 76-100% occur within 1 year after removal, identical to discontinuation of any other contraceptive method 3
- No residual contraceptive effect exists once the implant is physically removed from the subdermal space 2, 3
- Alternative contraception must be initiated immediately if pregnancy prevention is desired after removal 1
Duration of Effectiveness While In Place
The implant maintains contraceptive efficacy throughout its approved duration:
- Standard FDA-approved duration is 3 years for the etonogestrel implant 1, 4, 2
- Failure rate remains <1% throughout the entire 3-year period with typical use 1
- Contraceptive mechanism (ovulation suppression) continues uninterrupted until physical removal 2
Extended Use Beyond 3 Years
Emerging evidence suggests effectiveness may extend beyond the approved timeframe:
- Research demonstrates documented effectiveness for up to 5 years with no pregnancies in extended use studies 5
- One case report showed detectable serum etonogestrel levels persisting 6 years after insertion, though this is not recommended practice 5
- However, removal by the end of the third year remains the official recommendation 2
Critical Clinical Pitfall
The question "how long will an implant be effective if removed before its due date" reflects a fundamental misunderstanding. The implant does not have residual effectiveness after removal - it works only while physically present in the body. If removed at 1 year, 2 years, or 2.9 years, contraceptive protection stops immediately at the moment of removal, not at some future "due date." 2, 3
Backup Contraception Requirements After Removal
If continuing contraception is desired:
- Start alternative method immediately at the time of removal or before removal if switching methods 1
- When inserting a new implant immediately after removal, no backup contraception is needed 1
- When switching to other hormonal methods, follow standard initiation protocols with 7 days of backup contraception if not inserted within 5 days of menstrual bleeding 1