Initiation and continuation rates seen in 2-year experience with Same Day injections of DMPA

Background: Women often need prompt initiation of effective contraception. Quick Start/Same Day Start protocols for combined hormonal contraceptive methods have been extensively studied. Experience with Same Day injections of longer-acting progestins is less well reported. The Same Day injection protocol is comprehensive and includes emergency contraception, backup methods for 7 days and repeat pregnancy testing within 2-3 weeks. Study Design: This is a historical cohort study based on review of the charts of all women who received injections of depot medroxyprogesterone acetate (DMPA) at the Women's Health Care Clinic at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center between January 1, 2003, and December 31, 2004. Results: The study population included 1056 women who had a total of 3185 DMPA injections. More than 81% of the initial injections were given Same Day - outside the first 5 days of menses. At each reinjection, 14-27% of women were late and also benefited from rapid access to DMPA. Continuation rates were low in both groups but were not lower among those who utilized Same Day injections compared with On Time starters. Six pregnancies were diagnosed, all in the Same Day Start group. Conclusions: The introduction of DMPA as a Same Day injection policy is a safe and efficient way of providing women needed effective contraception within 7 days of the office visit. (c) 2007 Elsevier Inc. All rights reserved.