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Expired implant and UPSI — DFSRH MCQ

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HardProgestogen-only methodsExpired implant and UPSIDFSRH

A 24-year-old woman has an etonogestrel implant that expired 2 months ago. She has had UPSI twice in the last week and wants a replacement today. Pregnancy test is negative. What is the most appropriate management?

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

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Correct answer: E — Assess emergency contraception, replace or quick-start if appropriate, and arrange pregnancy test follow-up

An expired implant with recent UPSI requires EC assessment and pregnancy follow-up because a negative test today cannot exclude recent conception. Replacement or quick start may still be appropriate after counselling, but follow-up is crucial. Immediate implant insertion after UPA may reduce EC effectiveness, and delaying all contraception may increase risk. The pearl is that expiry changes management from routine replacement to pregnancy-risk assessment.

Reference: FSRH Guideline: Progestogen-only Implant; FSRH Guideline: Emergency Contraception