Department of Obstetrics and Gynecology and Clinical Research Center, Oulu University Hospital, Oulu, Finland.
Fertil Steril. 2013 Apr;99(5):1305-10. doi: 10.1016/j.fertnstert.2012.11.034. Epub 2012 Dec 20.
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.
Spin-off study of a prospective, randomized trial.
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.
NCT01087879.
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。
前瞻性、随机试验的衍生研究。
大学诊所。
54 名健康女性中有 42 名完成了研究。
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。
联合避孕药引起的血清激素水平变化。
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。
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。
NCT01087879。