Same day initiation of the etonogestrel (ENG) implant and oral ulipristal acetate (UPA) would
overcome contraceptive access barriers to women with recent unprotected intercourse to
ongoing contraception. Current clinical guidelines recommend delaying implant initiation for
at least 1 week following UPA, as well as waiting 7 days before relying on the implant for
contraception after initiation alone. This pilot will assess the effects of the implant alone
and the implant inserted with same-day as UPA usage on ovarian activity. A total of 40 women
desiring the implant, who are not at risk for pregnancy during the study timeline, will be
recruited. Participants will be randomized to implant alone or same-day implant + oral UPA.
Participants will have daily ultrasounds and blood draws to assess timing of ovulation for 1
week and then an exit visit at 14 days after randomization. The primary outcome is the
incidence of ovulation in the 2 randomized treatment groups. Participants may continue the
implant after the study per FDA guidelines and rely on it for contraception after the study
is completed.