Ugocsai G, Rózsa M, Ugocsai P
Department of Obstetrics and Gynecology, Academic Teaching Hospital, H-5900 Orosháza, Könd 59, Hungary.
Contraception. 2002 Dec;66(6):433-7. doi: 10.1016/s0010-7824(02)00431-6.
Endometrial surface changes by scanning electron microscope were studied in three women who intentionally took high doses of levonorgestrel as an emergency postcoital contraceptive. Based upon findings of a close link between endometrial receptivity and surface integrity, significant alterations of the uterine lining structure may represent a drug effect accomplishing endometrial contraception. High doses of levonorgestrel (4-6 times more than recommended) caused detectable changes on the surface regardless of the menstrual cycle phase when the medication was taken. Cycle classification was based on estradiol and progesterone hormone levels, which corresponded to the menstrual diary. Comparison to control specimens displayed marked restructuralization of the endometrium. As a main feature, the number of ciliated cells were reduced, and cilia disappeared in the proliferative and periovulatory phase. In the secretory phase, pinopodia disappeared and the endometrial integrity broke down. The contraceptive effect of levonorgestrel seems to be accomplished by alteration of the endometrial surface and, therefore, receptivity.
对三名故意服用大剂量左炔诺孕酮作为性交后紧急避孕药的女性进行了扫描电子显微镜下子宫内膜表面变化的研究。基于子宫内膜容受性与表面完整性之间密切联系的研究结果，子宫内膜结构的显著改变可能代表药物实现子宫内膜避孕的作用。无论服药时处于月经周期的哪个阶段，大剂量左炔诺孕酮（比推荐剂量高4至6倍）都会导致表面出现可检测到的变化。周期分类基于雌二醇和孕酮激素水平，这与月经日记相对应。与对照标本相比，子宫内膜显示出明显的结构重组。主要特征是，纤毛细胞数量减少，在增殖期和排卵期周围纤毛消失。在分泌期，微绒毛消失，子宫内膜完整性遭到破坏。左炔诺孕酮的避孕作用似乎是通过改变子宫内膜表面从而改变容受性来实现的。
