Delayed first injection of the once-a-month injectable contraceptive containing 25 mg of medroxyprogesterone acetate and 5 mg of E(2)-cypionate: effects on ovarian function.
OBJECTIVE
To assess whether women who were administered the first injection of DMPA+E(2)C on day 7 of their menstrual cycle (delayed injection) exhibit the same degree of ovarian suppression as women who receive it on day 5 of their menstrual cycle.


METHODS
Multicenter, randomized controlled trial.


METHODS
Reproductive health clinics.


METHODS
Women aged between 18 and 38 years (inclusive) willing to use DMPA+E(2)C as their method of contraception.


METHODS
Participants received a DMPA+E(2)C injection on day 5 (control group, n = 41) or day 7 (delayed-injection group, n = 117) of their menstrual cycle.


METHODS
Ovarian activity and follicular development determined by serial serum progesterone levels and vaginal ultrasound.


RESULTS
Participants who received DMPA+E(2)C on day 5 of their menstrual cycle (control group) exhibited no more than limited follicular growth (no follicle >16 mm). Of those women who received DMPA+E(2)C on day 7 of their menstrual cycle (delayed-injection group), 21 (18%) showed some follicular growth, of whom 4 (3%) ovulated.


CONCLUSIONS
The first injection of DMPA+E(2)C given on day 7 of a menstrual cycle does not provide the same inhibition of ovarian activity as that observed when it is administered on day 5 of the menstrual cycle.
Petta
C A
CA
Department of Obstetrics and Gynecology, Universidade Estadual de Campinas, São Paulo, Campinas, Brazil. cpetta@attglobal.net
Hays
M
M
Brache
V
V
Massai
R
R
Hua
Y
Y
Alvarez-Sánchez
F
F
Croxatto
H
H
d'Arcangues
C
C
Cook
L A
LA
Bahamondes
L
L
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D003692:Delayed-Action Preparations; D004958:Estradiol / Q000008:administration & dosage* / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D008597:Menstrual Cycle; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology; D010053:Ovary / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology*; D010060:Ovulation / Q000187:drug effects; D011374:Progesterone / Q000097:blood; D014463:Ultrasonography
D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D011374:Progesterone; D004958:Estradiol; C007630:estradiol 17 beta-cypionate; D017258:Medroxyprogesterone Acetate