In vivo assessment of the human sperm acrosome reaction and the expression of glycodelin-A in human endometrium after levonorgestrel-emergency contraceptive pill administration.
BACKGROUND
The objectives were firstly to assess acrosome reaction (AR) status of spermatozoa following uterine flushing, secondly to measure levonorgestrel (LNG) levels in serum and in uterine flushing fluid and finally to measure endometrial glycodelin-A expression after administration of LNG as a form of emergency contraception (EC).


METHODS
Forty-eight experiments were conducted on 15 regularly menstruating women. Four groups were formed based on different intercourse to treatment interval and treatment to recovery of spermatozoa and the biopsies.


RESULTS
Twenty-four and forty-eight hours after treatment, there were 14.5 +/- 3.9 x 10(6) and 17.3 +/- 6.8 x 10(6) sperm recovered from the uterus, respectively. There were no differences between the AR rate and the endometrial glycodelin-A staining intensity in an LNG or placebo treated cycles. The LNG in uterine flushing medium represented 1.38% of the values observed in serum 24 h after the LNG intake.


CONCLUSIONS
Twenty-four and forty-eight hours after administration of EC, neither the proportion of AR sperm, nor the glycodelin-A level was influenced by 1.5 mg of LNG. LNG did not impair the cervical mucus either because viable spermatozoa were found in the genital tract 36-60 h after coitus and 24-48 h after LNG intake. The mechanism of action of LNG as EC remains unknown.
do Nascimento
Josiane A A
JA
Human Reproduction Unit, Department of Obstetrics and Gynaecology, School of Medicine, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil.
Seppala
Markku
M
Perdigão
Antero
A
Espejo-Arce
Ximena
X
Munuce
Maria José
MJ
Hautala
Laura
L
Koistinen
Riitta
R
Andrade
Liliana
L
Bahamondes
Luis
L
D020101:Acrosome Reaction / Q000502:physiology*; D000328:Adult; D044363:Contraception, Postcoital; D003283:Contraceptives, Postcoital, Synthetic / Q000008:administration & dosage*; D004311:Double-Blind Method; D004717:Endometrium / Q000187:drug effects / Q000378:metabolism*; D005260:Female; D000071816:Glycodelin; D006023:Glycoproteins / Q000096:biosynthesis*; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000097:blood; D008297:Male; D011257:Pregnancy Proteins / Q000096:biosynthesis*
D003283:Contraceptives, Postcoital, Synthetic; D000071816:Glycodelin; D006023:Glycoproteins; C045246:PAEP protein, human; D011257:Pregnancy Proteins; D016912:Levonorgestrel