Ortho Evra/Evra versus oral contraceptives: follicular development and ovulation in normal cycles and after an intentional dosing error.
OBJECTIVE
To compare the effects of the contraceptive patch to oral contraceptives (OCs) on follicular size and incidence of ovulation in normal cycles and after dosing errors.


METHODS
Randomized, open-label.


METHODS
Twelve centers.


METHODS
One hundred twenty-four ovulatory women.


METHODS
Subjects received either the patch (groups 1 and 2) or one of three OCs. Correct dosing occurred in cycles 1, 2, 3, and 5. The following dosing errors were planned during cycle 4, a shortened 10-day cycle: [1] patch group 1 subjects wore one patch for 10 consecutive days; [2] for patch group 2 and OC subjects, 7 dosing days were followed by 3 drug-free days.


METHODS
Follicular size, as determined at each cycle by the maximum mean follicular diameter.


RESULTS
After a 3-day dosing error, follicular size was significantly smaller in the patch group (mean, 7.0 mm) vs. each OC group (range of means, 11.8-17.1 mm). Similar results were seen after proper dosing. The incidence of ovulation was significantly lower for the patch users than for women using OCs.


CONCLUSIONS
Follicular size and incidence of ovulation were significantly reduced among contraceptive patch users compared with women using OCs in normal cycles and after planned dosing errors.
Pierson
Roger A
RA
Obstetrics, Gynecology, and Reproductive Sciences, University of Saskatchewan, Saskatoon, Canada. pierson@erato.usask.ca
Archer
David F
DF
Moreau
Michèle
M
Shangold
Gary A
GA
Fisher
Alan C
AC
Creasy
George W
GW
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000494:pharmacology*; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage / Q000494:pharmacology*; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage / Q000494:pharmacology*; D004338:Drug Combinations; D004958:Estradiol / Q000097:blood; D045166:Estradiol Congeners / Q000008:administration & dosage / Q000494:pharmacology*; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000494:pharmacology*; D005003:Ethisterone / Q000031:analogs & derivatives; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008508:Medication Errors; D009644:Norgestrel / Q000031:analogs & derivatives; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology; D010060:Ovulation / Q000187:drug effects* / Q000502:physiology; D010091:Oximes; D011374:Progesterone / Q000097:blood; D014463:Ultrasonography
D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal; D004338:Drug Combinations; D045166:Estradiol Congeners; D010091:Oximes; D009644:Norgestrel; D004997:Ethinyl Estradiol; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D005003:Ethisterone; C449219:norelgestromin