Abstract
The effects of short-term administration of levonorgestrel (LNG) at different stages
of the ovarian cycle on the pituitary-ovarian axis, corpus luteum function, and endometrium
were investigated. Forty-five surgically sterilized women were studied during two
menstrual cycles. In the second cycle, each women received two doses of 0.75 mg LNG
taken 12 h apart on day 10 of the cycle (Group A), at the time of serum luteinizing
hormone (LH) surge (Group B), 48 h after positive detection of urinary LH (Group C),
or late follicular phase (Group D). In both cycles, transvaginal ultrasound and serum
LH were performed from the detection of urinary LH until ovulation. Serum estradiol
(E2) and progesterone (P4) were measured during the complete luteal phase. In addition, an endometrial biopsy
was taken at day LH + 9. Eighty percent of participants in Group A were anovulatory,
the remaining (three participants) presented significant shortness of the luteal phase
with notably lower luteal P4 serum concentrations. In Groups B and C, no significant differences on either cycle
length or luteal P4 and E2 serum concentrations were observed between the untreated and treated cycles. Participants
in Group D had normal cycle length but significantly lower luteal P4 serum concentrations. Endometrial histology was normal in all ovulatory-treated cycles.
It is suggested that interference of LNG with the mechanisms initiating the LH preovulatory
surge depends on the stage of follicle development. Thus, anovulation results from
disrupting the normal development and/or the hormonal activity of the growing follicle
only when LNG is given preovulatory. In addition, peri- and post-ovulatory administration
of LNG did not impair corpus luteum function or endometrial morphology.
Keywords
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References
- Metabolism of levonorgestrel, norethindrone, and structurally related contraceptive steroids.Contraception. 1990; 42: 67-96
- Biological effects of racemic and resolved 13β-ethyl-4gonen-3-ones.Steroids. 1963; 2: 731
- Levonorgestrel subdermal implants. A review of contraceptive efficacy, and acceptability.Drugs. 1998; 55: 861-887
- Emergency postcoital contraception.N Engl J Med. 1997; 337: 1058-1064
- Randomized controlled trial of levonorgestrel versus the Yuzpe regimen of combined contraceptives for emergency contraception.Lancet. 1998; 352: 428-433
- Mode of action of dl-norgestrel and ethinylestradiol combination in postcoital contraception.Fertil Steril. 1979; 32: 297-302
- Mode of action of dl-norgestrel and ethinylestradiol combination in postcoital contraception. II. Effects of postovulatory administration on ovarian function and endometrium.Fertil Steril. 1983; 39: 292-297
- Mode of action of dl-norgestrel and ethinylestradiol combination in postcoital contraception. III. Effects of preovulatory administration following the luteinizing hormone surge on ovarian steroidogenesis.Fertil Steril. 1983; 40: 631-636
- Effect of post-coital contraceptive methods on the endometrium, and the menstrual cycle.Acta Obstet Gynecol Scand. 1996; 75: 738-744
- The hormonal, and peripheral effects of d-norgestrel in postcoital contraception.Contraception. 1974; 10: 411-424
- Biological, microscopic, and scanning electron microscopic investigations of the effects of Postinor/d-norgestrel in rabbits.Contraception. 1984; 30: 153-159
- The effects of levonorgestrel administered in large doses at different stages of the cycle on ovarian function, and endometrial morphology.Contraception. 1989; 39: 275-289
- Study on the action of d-norgestrel as a postcoital contraceptive agent.Contraception. 1975; 11: 31-43
- Luteinizing hormone, and progesterone in women under postcoital contraception with d-norgestrel.Fertil Steril. 1976; 27: 1250-1255
- Timing the sexual intercourse in relation to ovulation.N Engl J Med. 1995; 333: 1517-1521
- Ultrasonic indices of ovulation.J Reprod Med. 1986; 31: 764-769
- The implantation window.Baillieres Clin Obstet Gynaecol. 1992; 6: 351-371
- Endometrial receptivity in the light of modern assisted reproductive technologies.Fertil Steril. 1994; 62: 225-232
- The usefulness of a urinary LH kit for ovulation prediction during menstrual cycles of normal women.Obstet Gynecol. 1996; 87: 13-17
- Evidence for an altered luteinizing hormone sensitivity to naloxone in pathological hyperprolactinaemia.Clin Endocrinol. 1995; 43: 591-600
- Hypothalamic dopaminergic tone and prolactin bioactivity in women with polycystic ovary syndrome.Arch Med Res. 2000; 31: 216-222
- Endometrial morphology, and peripheral hormone levels in women with regular menstrual cycles.Fertil Steril. 1987; 48: 401-408
- Dating the endometrial biopsy.Fertil Steril. 1950; 1: 3-25
- Normal histology of the uterus and fallopian tubes.in: Sternberg S.S Histology for pathologist. Lippincott-Raven, Philadelphia-New York1997: 879-927
- Use of integrins to date the endometrium.Fertil Steril. 2000; 73: 779-787
- Endometrial receptivity and the luteal phase.Curr Opin Obstet Gynecol. 1992; 4: 736-742
- Lognormal distributions.Nature. 1945; 156: 463-466
- Statistical inference.in: Swarbrick J Pharmaceutical statistics practical, and clinical applications. Marcel Dekker Inc, New York1990: 146-157
- A prospective randomized comparison of levonorgestrel with the Yuzpe regimen in post-coital contraception.Hum Reprod. 1993; 8: 389-392
- The use of progestogens as postcoital contraceptives.J Reprod Med. 1974; 13: 58-61
- In vitro actions of progestogens on sperm migration in human cervical mucus.Fertil Steril. 1975; 26: 57-61
- Results of a multicentric trial of Postinor.Ther Hung. 1982; 30: 72-78
- Progesterone-induced atresia of the proestrous dominant follicle in the bovine ovary.Biol Reprod. 1997; 57: 580-587
- Progestins inhibit FSH-stimulated steroidogenesis in cultured rat granulosa cells.Mol Cell Endocrinol. 1980; 19: 165-173
- Progestrone inhibits the induction of aromatase activity in rat granulosa cells in vitro.Biol Reprod. 1983; 28: 1078-1089
- Antifolliculogenic action of progesterone despite hypersecretion of FSH in monkeys.Am J Physiol. 1982; 243: E387-E397
- Effect on an oral contraceptive on adrenal, and ovarian androgenic steroids.Obstet Gynecol. 1984; 63: 12-14
- Progesterone-induced luteinizing and follicle-stimulating hormone surge in postmenopausal women.Proc Natl Acad Sci USA. 1968; 61: 529-536
- Progesterone advancement of estrogen-induced luteinizing hormone release during the midfollicular phase in normal cyclic women.J Endocrinol. 1976; 71: 451-452
- Hormonal dynamics at midcycle.J Clin Endocrinol Metab. 1983; 57: 792-796
- Evidence for a critical role of progesterone in the regulation of the midcycle gonadotropin surge, and ovulation.J Clin Endocrinol Metab. 1992; 74: 565-570
- Progesterone modulation of pulsatile luteinizing hormone secretion in women.J Clin Endocrinol Metab. 1984; 58: 378-383
- Research on new methods of emergency contraception.J Reprod Med. 1996; 5: 12-18
- Mice lacking progesterone receptor exhibit pleiotropic reproductive abnormalities.Genes Dev. 1995; 9: 2266-2278
- Studies on the mechanism of edematous changes at the endometrial stroma for implantation.Semin Thromb Hemost. 2001; 27: 67-77
- Decidual spiral artery remodeling begins before cellular interaction with cytotrophoblasts.Placenta. 1998; 19: 241-252
- Trophoblast cell-mediated modifications to uterine spiral arteries during early gestation in the macaque.Acta Anat. 1997; 158: 227-236
- Effect of the Yuzpe regimen of emergency contraception on markers of endometrial receptivity.Hum Reprod. 2000; 15: 2351-2355
Article info
Footnotes
☆This study was supported by grants from Family Health International (North Carolina, USA), US Agency for International Development (Washington, DC, USA), the Andrew W. Mellon Foundation (New York, USA), and El Consejo Nacional de Ciencia y Tecnologı́a (Mexico).
Identification
Copyright
© 2001 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
