Hidalgo Maria Margarete, Lisondo Claudio, Juliato Cássia Teatin, Espejo-Arce Ximena, Monteiro Ilza, Bahamondes Luis
Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medicine, Universidade Estadual de Campinas (UNICAMP), 13084-971, Campinas, SP, Brazil.
Contraception. 2006 May;73(5):532-6. doi: 10.1016/j.contraception.2005.12.012. Epub 2006 Mar 29.
To evaluate the prevalence of ovarian cysts in users of two contraceptive implants compared to users of intrauterine contraceptive (IUC).
A total of 344 women were enrolled at 3 months of use of the etonogestrel-releasing implant (Implanon), the levonorgestrel-releasing implant (Jadelle) or the TCu380A IUC. Bimanual pelvic examination and vaginal ultrasound were performed during routine 3-, 6- and 12-month visits of asymptomatic women. Women with ovarian cysts (or enlarged ovarian follicles > or = 25 mm) were assessed weekly until disappearance or reduction of the image [including estradiol (E2) and progesterone (P) measurement], and women with no ovarian enlargement underwent the same evaluation for the same period of time.
Ovarian cysts were detected in 5.2%, 13.0% and 1.9% of users of Implanon, Jadelle and IUC, respectively, at 3 months. At 6 months of use, prevalence was 7.2%, 8.0% and 2.1%, whereas 12-month rates were 26.7%, 14.6% and 1.2% in the three groups, respectively. E2 levels were significantly higher among users with ovarian cysts than controls. The time until disappearance of the ovarian cyst was similar in all three groups. There were more cases of menorrhagia in users of implants who had ovarian cysts than in those with no ovarian enlargement.
The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon and Jadelle implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.
评估两种避孕植入剂使用者与宫内节育器（IUC）使用者相比卵巢囊肿的患病率。
共有344名女性在使用依托孕烯释放植入剂（Implanon）、左炔诺孕酮释放植入剂（Jadelle）或TCu380A IUC 3个月时入组。在无症状女性的常规3个月、6个月和12个月随访期间进行双合诊盆腔检查和阴道超声检查。对患有卵巢囊肿（或卵巢卵泡增大≥25 mm）的女性每周进行评估，直至图像消失或缩小[包括测量雌二醇（E2）和孕酮（P）]，而未出现卵巢增大的女性在同一时间段内接受相同评估。
在3个月时，Implanon、Jadelle和IUC使用者中卵巢囊肿的检出率分别为5.2%、13.0%和1.9%。使用6个月时，患病率分别为7.2%、8.0%和2.1%，而三组在12个月时的患病率分别为26.7%、14.6%和1.2%。患有卵巢囊肿的使用者的E2水平显著高于对照组。三组中卵巢囊肿消失的时间相似。有卵巢囊肿的植入剂使用者中月经过多的病例比没有卵巢增大的使用者更多。
在使用Implanon和Jadelle植入剂的第一年发现卵巢囊肿或卵巢卵泡增大很常见且是短暂的，不应被解释为病理性卵巢囊肿。无需进一步的医学干预。
