A 32-year-old woman with a BMI of 35 presents requesting con…

A 32-yeаr-оld wоmаn with а BMI оf 35 presents requesting contraception. She reports irregular menstrual cycles and is concerned that her weight may affect the safety and effectiveness of hormonal contraceptives. She desires a highly reliable method of pregnancy prevention and prefers to avoid systemic hormones if possible. Which contraceptive option is most appropriate?