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Quick start implant after UPSI — DFSRH MCQ

Instant feedback + full explanation. One question, done properly.

ModerateProgestogen-only methodsQuick start implant after UPSIDFSRH

A 33-year-old woman has an etonogestrel implant inserted 12 days ago. She reports UPSI 2 days before insertion, has no bleeding, and a pregnancy test today is negative. What would you advise this patient?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Repeat a pregnancy test at least 21 days after the UPSI

A pregnancy test may be falsely negative until at least 21 days after UPSI, so repeat testing is needed when quick-starting after recent risk. Removing the implant is unnecessary unless pregnancy occurs and the patient wishes it removed. UPA 12 days after UPSI is outside its licensed EC window, and CHC bridging adds risk without solving the diagnostic issue. The pearl is that quick start is acceptable when pregnancy cannot be excluded, but follow-up testing is essential.

Reference: FSRH Guideline: Quick Starting Contraception; FSRH Guideline: Progestogen-only Implant