Case 90 - A 26-Year-Old Female Presents for Nexplanon Removal with a Non-palpable Device

Summary

A 26-year-old woman, gravida 1, para 1, presents for removal of an etonogestrel (Nexplanon) contraceptive implant after utilizing it for contraception for 28 months. The device was initially placed by her primary care provider (PCP). In the referral notes, the PCP describes that she was not able to palpate the device. She ordered an ultrasound of the left arm, which confirmed the presence of the Nexplanon implant in the arm. The patient is requesting removal as she now desires another pregnancy. She reports satisfaction with Nexplanon as a contraceptive method. She does report menstrual irregularities since device placement, but since the result was lighter, less frequent menses, these changes were acceptable to her. She reports she has gained approximately 10 lb since the device was placed, but she attributes this to unhealthy eating habits and decreased physical activity. She denies any pain, numbness, tingling, or weakness in her upper extremity. Her past medical history is significant for childhood asthma and surgical history for wisdom tooth extraction. She is taking multivitamins and has no known drug allergies.