title: Timing of onset of contraceptive effectiveness in Norplant implant users. II. Effect on the ovarian function in the first cycle of use.
abstract: The objective of this study was to time the onset of contraceptive effectiveness in Norplant implant users, when the capsules were inserted beyond the first 7 days of the cycle, based on the immediate effect on the ovarian activity. A total of 42 healthy women requesting Norplant implant contraception were enrolled at clinics in Santo Domingo, Dominican Republic, and in Baltimore, Maryland. Implants were inserted on days 8-13 of the menstrual cycle. Blood samples for estradiol (E2), progesterone (P), luteinizing hormone (LH) (in a subset of 12 women), and levonogestrel (LNG) assay, were taken at 0 h and at 6, 12, 24, 72, and 168 h postinsertion. Ovulation, as defined by P > 2.5 ng/mL, occurred in 40% of subjects. A short lasting, frequently blunted, LH peak occurred within 12 h postinsertion, in all these subjects. The remaining subjects had anovulatory cycles with two distinct E2 profiles: continuously increasing E2 levels to a high mean of 414.3 pg/mL (28%), or no sustained increase in E2 (32%). Most cycles (86%) in which Norplant was inserted with high E2 levels (> 175 pg/mL) were ovulatory, whereas none were ovulatory with low E2 (< 100 pg/mL) at insertion. Based on the endocrine effects of Norplant implant insertion in the midadvanced follicular phase, in which ovulation will either occur within 48 h of insertion or will be impaired, additional contraceptive protection is necessary only for 3 days.
authors.affiliation: Biomedical Research Department, PROFAMILIA, Santo Domingo, Dominican Republic.
authors.forename: V
authors.initials: V
authors.lastname: Brache
authors.forename: P D
authors.initials: PD
authors.lastname: Blumenthal
authors.forename: F
authors.initials: F
authors.lastname: Alvarez
authors.forename: T R
authors.initials: TR
authors.lastname: Dunson
authors.forename: L
authors.initials: L
authors.lastname: Cochon
authors.forename: A
authors.initials: A
authors.lastname: Faundes
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D004343:Drug Implants; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007700:Kinetics; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle; D011374:Progesterone / Q000097:blood; D013997:Time Factors
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants; D011374:Progesterone; D004958:Estradiol; D016912:Levonorgestrel; D007986:Luteinizing Hormone