Brache V, Alvarez-Sanchez F, Faundes A, Tejada A S, Cochon L
CINSERHA--PROFAMILIA, Santo Domingo, Dominican Republic.
Contraception. 1990 Feb;41(2):169-77. doi: 10.1016/0010-7824(90)90145-l.
Ovarian endocrine function was assessed in 88 women using NORPLANT subdermal implants during different periods of use and in a control group of 15 women using non-hormonal contraception. Blood samples for estradiol (E2) and progesterone (P) assays were obtained twice a week for five consecutive weeks. Three distinct E2 patterns were observed: one was characterized by fluctuating levels within a normal range (20 to 400 pg/ml), a second pattern corresponded to continuous low E2 levels (below 75 pg/ml in the 10 samples) and the third was characterized by high broad estradiol peaks reaching over 400 pg/ml. The proportion of sampling runs characterized by normal fluctuating levels increased from 38% in the first two years of use to 80% during the fifth year of use. Low E2 profile was only observed during the first two years of use (27%) and in only 1 case at the beginning of the third year of use (5%). The percentage of cycles with high broad estradiol peaks remained between 20-40% without a clear tendency to change in either direction with duration of use. Thirty-three percent of the observed sampling runs had luteal activity (P above 3 ng/ml). The proportion of runs with luteal activity increased from 14% during the first two years of use to 40% during the third and fourth, and 60% during the fifth year of use. All control subjects had luteal activity. The mean highest progesterone level was lower in the NORPLANT runs (8.7 +/- 3.9 ng/ml) as compared to the controls (11.3 +/- 3.8 ng/ml). NORPLANT sampling runs with luteal activity had normal fluctuating E2 levels with only one exception. However, not all cycles with normal E2 levels showed luteal activity. On the other hand, all runs with low E2 levels or high broad E2 peaks were without luteal activity. In summary, women using continuous low-dose levonorgestrel contraception through NORPLANT subdermal implants, have a variable degree of ovarian activity as compared with the more complete depression of ovarian function observed among pill or injectables' users. Ovarian activity becomes closer to normal during the third through fifth year of use.
在88名使用皮下诺普兰植入剂的女性不同使用阶段，以及15名使用非激素避孕方法的女性组成的对照组中，评估了卵巢内分泌功能。连续五周每周两次采集血样用于检测雌二醇（E2）和孕酮（P）。观察到三种不同的E2模式：一种模式的特征是在正常范围内波动（20至400 pg/ml），第二种模式对应持续低E2水平（10个样本中低于75 pg/ml），第三种模式的特征是出现超过400 pg/ml的高宽峰雌二醇。以正常波动水平为特征的采样次数比例从使用的前两年的38%增加到使用第五年的80%。低E2水平仅在使用的前两年观察到（27%），在使用第三年开始时仅1例（5%）。高宽峰雌二醇周期的百分比保持在20 - 40%之间，未随使用时间出现明显的变化趋势。观察到的采样次数中有33%有黄体活动（P高于3 ng/ml）。有黄体活动的采样次数比例从使用前两年的14%增加到第三年和第四年的40%，以及使用第五年的60%。所有对照受试者都有黄体活动。与对照组（11.3 +/- 3.8 ng/ml）相比，诺普兰采样中有黄体活动的平均最高孕酮水平较低（8.7 +/- 3.9 ng/ml）。有黄体活动的诺普兰采样中E2水平正常波动，仅有一个例外。然而，并非所有E2水平正常的周期都有黄体活动。另一方面，所有E2水平低或高宽峰E2的采样都没有黄体活动。总之，与口服避孕药或注射剂使用者中观察到的更完全的卵巢功能抑制相比，通过皮下诺普兰植入剂使用持续低剂量左炔诺孕酮避孕的女性，卵巢活动程度存在差异。在使用的第三至第五年，卵巢活动更接近正常。
