title: Ovulation and follicular development associated with three low-dose oral contraceptives: a randomized controlled trial.
abstract: OBJECTIVE
  To address the hypothesis that multiphasic oral contraceptives (OCs) increase rather than decrease the risk of functional ovarian cysts.
  
  
  METHODS
  In this single-center, randomized controlled study, women were assigned to a multiphasic pill, a lower-dose monophasic pill, a higher-dose monophasic pill, or nonsteroidal contraception. Forty volunteers were randomized (ten each) to three different pill regimens or to nonsteroidal contraception. During 6 months of treatment, follicular development was measured by vaginal ultrasonography and ovulation was indicated by serum progesterone levels.
  
  
  RESULTS
  The relative risk (RR) of developing a follicular structure greater than 30 mm in diameter during a cycle with the higher-dose monophasic pill was 0.5 (95% confidence interval [CI] 0.1-1.9; P = .49) compared with the multiphasic pill. The risk with the lower-dose monophasic pill was comparable to that with the multiphasic pill (RR 1.3, 95% CI 0.5-3.6; P = .56). With the multiphasic pill, the maximum ovulation rate over 60 cycles was 1.7 per 100 cycles (95% CI 0.0-8.9).
  
  
  CONCLUSIONS
  This multiphasic pill more closely resembled the lower-dose monophasic pill than the higher-dose monophasic pill in its suppression of follicular development.
authors.affiliation: Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
authors.forename: D A
authors.initials: DA
authors.lastname: Grimes
authors.forename: A J
authors.initials: AJ
authors.lastname: Godwin
authors.forename: A
authors.initials: A
authors.lastname: Rubin
authors.forename: J A
authors.initials: JA
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Lacarra
mesh_terms: D000328:Adult; D004997:Ethinyl Estradiol / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D006801:Humans; D009640:Norethindrone / Q000008:administration & dosage* / Q000494:pharmacology; D006080:Ovarian Follicle / Q000187:drug effects* / Q000502:physiology*; D010060:Ovulation / Q000187:drug effects*; D011446:Prospective Studies
chemical_list: D004997:Ethinyl Estradiol; D009640:Norethindrone