Department of Reproductive Biology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Mexico City 14000, Mexico.
Contraception. 2010 Dec;82(6):526-33. doi: 10.1016/j.contraception.2010.05.015. Epub 2010 Aug 4.
The study was conducted to assess the effects of levonorgestrel (LNG) on hormonal behavior and on the secretory pattern of intrauterine glycodelin at the midcycle of ovulatory women.
Thirty healthy sterilized women with normal ovarian function were studied during one control untreated cycle and one LNG-treated cycle. In the treated cycle, each woman received two doses of 0.75 mg of LNG 12 h apart during the preovulatory phase approximately 2 days before the LH surge. Daily follicle development recordings were performed until follicle rupture was observed, and serum glycodelin, LH, estradiol, estrone and progesterone were measured as well. In addition, glycodelin concentrations were assayed in uterine flushing obtained on Days LH+1 and LH+12.
LNG did not modify follicle rupture in 20 of 30 women. In spite of ovulatory progesterone and the occurrence of follicle rupture in these women, luteal phase length was significantly decreased, as well as the serum concentrations of LH, estradiol and estrone in the periovulatory phase. Glycodelin in serum and uterine flushings was significantly elevated in the periovulatory phase when compared to control cycles.
LNG taken at the dose used in emergency contraception before the LH surge increased prematurely serum and intrauterine concentrations of glycodelin at the time of ovulation. Since there are well established glycodelin inhibitory effects upon fertilization, these results may represent an additional action of LNG in situations where the intervention did not interfere with ovulation.
本研究旨在评估左炔诺孕酮（LNG）对排卵女性激素行为和蜕膜蛋白 12（glycodelin）分泌模式的影响。
30 名具有正常卵巢功能的健康绝育女性在一个对照未治疗周期和一个 LNG 治疗周期中接受了研究。在治疗周期中，在 LH 峰前大约 2 天的预排卵期，每个女性每隔 12 小时接受两次 0.75mg 的 LNG 治疗。直到观察到卵泡破裂为止，每天进行卵泡发育记录，并测量血清 glycodelin、LH、雌二醇、雌酮和孕酮。此外，还测定了 LH+1 和 LH+12 日子宫冲洗液中的 glycodelin 浓度。
LNG 未改变 30 名女性中的 20 名的卵泡破裂。尽管这些女性的黄体期孕酮和卵泡破裂发生，但黄体期长度明显缩短，围排卵期的 LH、雌二醇和雌酮血清浓度也明显降低。与对照周期相比，围排卵期血清和子宫冲洗液中的 glycodelin 明显升高。
在 LH 峰前紧急避孕时使用的剂量的 LNG 在排卵时提前增加了血清和子宫内 glycodelin 的浓度。由于已经确立了 glycodelin 对受精的抑制作用，这些结果可能代表了 LNG 在干预不干扰排卵的情况下的另一种作用。
