Contraceptive implants

Described in this letter is a case in which migration of a levonorgestrel contraceptive implant exceeded 2 cm. An earlier editorial stated that such an event has never occurred. In this case involving a 30-year-old UK woman two capsules remained in a satisfactory location fanned out from the insertion site. The third fourth and fifth capsules however migrated cranially by 15 mm 40 mm and 40 mm respectively while the sixth had migrated over 50 mm caudally. The capsules had been inserted by a general practitioner with training and experience in this function. All capsules were located with high resolution ultrasonography. Removal was facilitated by marking the skin directly over the length of the implant and recording the depth beneath the surface.