College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, USA.
Contraception. 2022 Aug;112:37-42. doi: 10.1016/j.contraception.2022.03.022. Epub 2022 Mar 26.
To explore the effect on ovarian activity and ovulation of 28 days of correct daily use of a progestogen-only pill containing norgestrel 0.075 mg.
We performed a prospective, randomized, crossover study at 2 US sites, recruiting healthy women of reproductive age to use norgestrel 0.075 mg daily for three 28-day treatment cycles. We monitored ovarian activity every 3 to 4 days with reproductive hormone measurements and ovarian ultrasonography. Participants recorded pill use in daily diaries. An adjudication committee independent of the research sites assessed ovarian activity using a modified Hoogland score combining hormone concentrations and follicle diameter and appearance (quiescence 1-3, ovarian activity without ovulation 4-5, and ovulatory/postovulatory 6-7).
We report here the findings of the initial 28-day treatment cycle in which 51 of 52 recruited participants provided data sufficient for analysis. Two thirds of subjects had no evidence of ovulation (34/51, 66.6%); eight of these (15.7%) had quiescent ovaries (follicle <13 mm diameter) and 26 (51%) had follicular development (follicle >13 mm diameter) without ovulation. Seventeen participants ovulated, of whom 12 (23.5%) had a normal, and 5 (9.8%) an abnormal luteal phase. Persistent ovarian follicles were common among women who had ovarian activity without ovulation, 17 of 26 participants (65.4%) had a large follicle which persisted beyond 28 days.
During 28 days of exposure to a norgestrel 0.075 mg progestogen-only pill, most women had no evidence of ovulation.
Ovulation inhibition and follicle growth disturbance are important in the mechanism of action of a progestogen-only pill containing norgestrel 0.075 mg.
探讨每日正确使用含去氧孕烯 0.075 毫克的单纯孕激素避孕药 28 天对卵巢活动和排卵的影响。
我们在美国的 2 个地点进行了一项前瞻性、随机、交叉研究，招募了生育年龄的健康女性，让她们每天使用去氧孕烯 0.075 毫克，连续使用三个 28 天的治疗周期。我们每 3 到 4 天通过生殖激素测量和卵巢超声监测卵巢活动。参与者在每日日记中记录药物使用情况。一个独立于研究地点的裁决委员会使用结合激素浓度和卵泡直径及外观的改良 Hoogland 评分（静止 1-3 期、无排卵的卵巢活动 4-5 期和排卵/排卵后 6-7 期）评估卵巢活动。
我们在此报告初始 28 天治疗周期的研究结果，其中 52 名招募参与者中的 51 名提供了足够分析的数据。三分之二的受试者没有排卵证据（34/51，66.6%）；其中 8 名（15.7%）有静止的卵巢（卵泡直径<13 毫米），26 名（51%）有卵泡发育（卵泡直径>13 毫米）但无排卵。17 名参与者排卵，其中 12 名（23.5%）黄体期正常，5 名（9.8%）黄体期异常。无排卵的卵巢活动患者中，持续性卵巢卵泡很常见，26 名参与者中有 17 名（65.4%）有一个大卵泡持续超过 28 天。
在暴露于去氧孕烯 0.075 毫克单纯孕激素避孕药 28 天期间，大多数女性没有排卵证据。
排卵抑制和卵泡生长障碍是含去氧孕烯 0.075 毫克的单纯孕激素避孕药作用机制中的重要因素。
