(Replaces Practice Bulletin Number 121, July 2011)
Intrauterine devices and contraceptive implants, also called long-acting reversible contraceptives (LARC), are the
most effective reversible contraceptive methods. The major advantage of LARC compared with other reversible contraceptive
methods is that they do not require ongoing effort on the part of the patient for long-term and effective use.
In addition, after the device is removed, the return of fertility is rapid (1, 2). The purpose of this Practice Bulletin is
to provide information for appropriate patient selection and evidence-based recommendations for LARC initiation
and management. The management of clinical challenges associated with LARC use is beyond the scope of this document
and is addressed in Committee Opinion No. 672, Clinical Challenges of Long-Acting Reversible Contraceptive
Reference: ACOG Practice Bulletin #186: Long-Acting Reversible Contraception: Implants and Intrauterine Devices. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017;130:e251–269.