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使用联合避孕药的女性,其抗缪勒管激素水平下降,与给药途径无关。

Antimüllerian hormone levels decrease in women using combined contraception independently of administration route.

机构信息

Department of Obstetrics and Gynecology and Clinical Research Center, Oulu University Hospital, Oulu, Finland.

出版信息

Fertil Steril. 2013 Apr;99(5):1305-10. doi: 10.1016/j.fertnstert.2012.11.034. Epub 2012 Dec 20.

Abstract

OBJECTIVE

To compare the effects of continuous use of oral (OC), transdermal, and vaginal combined contraceptives on the pituitary-ovarian axis and inhibition of follicular development.

DESIGN

Spin-off study of a prospective, randomized trial.

SETTING

University clinic.

PATIENT(S): Forty-two of 54 healthy women completed the study.

INTERVENTION(S): Treatment with combined OCs (ethinyl E2 [EE] and desogestrel), transdermal patches (EE and norelgestromin), or vaginal rings (EE and etonogestrel) for 9 weeks continuously. Blood sampling was performed before and at 5 and 9 weeks of treatment.

MAIN OUTCOME MEASURE(S): Changes in serum hormone levels induced by combined contraceptives.

RESULT(S): Serum antimüllerian hormone (AMH), FSH, inhibin B, LH, and E2 levels had decreased significantly in all study groups after 9 weeks of treatment. Significant declines were already detected after 5 weeks' use of combined contraceptives with regard to all hormone levels apart from those of serum AMH, where the decrease between baseline and 5 weeks was only moderate. Between groups, serum levels of AMH, inhibin B, LH, and E2 were comparable at baseline and after 5 and 9 weeks of treatment.

CONCLUSION(S): The decrease of serum AMH levels during the use of all combined contraceptives indicates that folliculogenesis is arrested independently of administration route.

CLINICAL TRIAL REGISTRATION NUMBER

NCT01087879.

摘要

目的

比较连续使用口服避孕药(OC)、经皮和阴道联合避孕药对垂体-卵巢轴和卵泡发育抑制的影响。

设计

前瞻性、随机试验的衍生研究。

地点

大学诊所。

患者

54 名健康女性中有 42 名完成了研究。

干预措施

连续 9 周用复方 OC(乙炔雌二醇[EE]和去氧孕烯)、经皮贴剂(EE 和诺孕酯)或阴道环(EE 和依托孕烯)治疗。在治疗前和第 5 周和第 9 周进行采血。

主要观察指标

联合避孕药引起的血清激素水平变化。

结果

所有研究组在治疗 9 周后,血清抗苗勒管激素(AMH)、FSH、抑制素 B、LH 和 E2 水平均显著下降。除了血清 AMH 水平外,所有激素水平在使用复方避孕药 5 周后就已经明显下降,而 AMH 水平在基线和 5 周之间的下降只是中度的。在基线和治疗 5 周和 9 周时,各组之间的血清 AMH、抑制素 B、LH 和 E2 水平无差异。

结论

所有联合避孕药使用期间血清 AMH 水平的下降表明卵泡发生被独立于给药途径所抑制。

临床试验注册号

NCT01087879。

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