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|Title: ||Neuroendocrine mechanism of anovulation in users of contraceptive subdermal implant of nomegestrol acetate (Uniplant)|
|Other Titles: ||Fertility and Sterility|
|Authors: ||Barnhart, Kurt T.|
Sir Pettermann, Teresa
Coutinho, Elsimar Metzker
|Keywords: ||Nomegestrol acetate subdermal implants;LH pulse hypothalamic pituitary fimction|
|Issue Date: ||1997|
|Abstract: ||Objective: To evaluate a nomegestrol acetate subdermal contraceptive implant's (Uniplant; Thermex, Monaco) effect on the hypothalamus-pituitary-ovarian axis.
Design: A prospective clinical trial.
Setting: San Borja-Arriarán Clinical Hospital, University of Chile, School of Medicine.
Patient(s): Normally cycling healthy women.
Intervention(s): Insertion of Uniplant.
Main Outcome Measure(s): Luteinizing hormone pulse and endocrine profiles were assessed before, 48 hours after insertion, and after prolonged use of the implant.
Result(s): Anovulation was noted in 100% of users in the first month. Seventy percent of subjects demonstrated follicular development with the absence of ovulation and an endocrine profile similar to the follicular phase: (LH pulse/8 hours 6.85 ± 0.67, LH amplitude 3.54 ± 0.65 mlU/mL (conversion factor to SI unit, 1.00), and E2 193 ± 29.4 pg/mL (conversion factor to SI unit, 3.67), whereas 30% demonstrated no follicular activity with an endocrine profile similar to the luteal phase: (LH pulse/8 hours; 3.66 ± 0.66, LH amplitude 5.76 ± 1.73 mlU/mL, and E2 67.5 ± 4 pg/mL. Clinical characteristics, serum gonadotropin concentration, and LH pulse characteristics failed to predict which subjects would initiate or remain devoid of follicular activity.
Conclusion(s): Uniplant results in anovulation via two mechanisms: hypothalamic suppression in subjects who lack follicular development, and likely suppression of the pituitary LH surge in subjects who initiate follicular activity.|
|Description: ||Texto completo: acesso restrito. p.250–255|
|Appears in Collections:||Artigos Publicados em Periódicos (Medicina)|
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