Prevalence of enlarged ovarian follicles among users of levonorgestrel subdermal contraceptive implants (Norplant).
OBJECTIVE
The aim of this study was to determine the prevalence of enlarged follicles, as detected by a single clinical or ultrasonographic examination, among users of levonorgestrel subdermal contraceptive implants (Norplant implants).


METHODS
This was a cross-sectional study of 103 users of Norplant implants and 50 users of the TCu380A intrauterine contraceptive device, all of whom received reproductive health services from PROFAMILIA, Santo Domingo, Dominican Republic. Bimanual pelvic examination and vaginal ultrasonography were performed. Enlarged follicles (>25 mm) were followed up weekly. The chi(2) test was applied to these data.


RESULTS
Enlarged follicles were detected by ultrasonography in 17. 5% of Norplant implants users and 4% of TCu380A intrauterine contraceptive device users, respectively (P <.04). There was no difference according to duration of use. The longest time to involution of the follicles was 4 weeks. Forty percent of the enlarged follicles detected by ultrasonography were also detected by bimanual pelvic examination.


CONCLUSIONS
Enlarged follicles are a frequent finding among women who use Norplant implants, but they are less frequent than described in previous studies, which were based on serial ultrasonographic scans in selected groups of users. Physicians and users should be aware of the transient nature of these enlarged follicles, which do not require intervention.
Alvarez-Sanchez
F
F
Biomedical Research Department, PROFAMILIA, Inc, and the Centro de Pesquisa das Doencas Materno-infantis de Campinas (CEMICAMP).
Brache
V
V
de Oca
V M
VM
Cochon
L
L
Faúndes
A
A
D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000494:pharmacology*; D004343:Drug Implants; D004958:Estradiol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007434:Intrauterine Devices; D016912:Levonorgestrel / Q000008:administration & dosage / Q000494:pharmacology*; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D010808:Physical Examination; D014463:Ultrasonography
D003271:Contraceptive Agents, Female; D004343:Drug Implants; D004958:Estradiol; D016912:Levonorgestrel