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Br J Hosp Med. 1991 Jun;45(6):372-5.


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Department of Obstetrics and Gynaecology, Edinburgh University.



Progesterone receptor antagonists such as mifepristone (also known as RU-486) have revolutionary potential as fertility control agents. Proven uses of RU-486 include early pregnancy termination, cervical ripening, postcoital contraception, ovulation inhibition, induction of labor after fetal death, and treatment of Cushing's syndrome. Under investigation is the use of this agent as a contraceptive and for the induction of labor at term, the treatment of progesterone-dependent cancers, and manipulation of the implantation window in in vitro fertilization. Most attention has centered on RU-486's abortifacient properties. Abortion is induced in about 62% of pregnancies under 57 days of gestation. When used in combination with exogenous prostaglandin, RU-486's effectiveness as an abortifacient is increased to 95-100%. RU-486 further provides researchers with an opportunity to explore the effects of progesterone in a variety of physiological situations. When administered in the luteal phase of the menstrual cycle, RU-486 induces luteolysis and vaginal bleeding. At this stage, the agent appears to act as a progesterone against on the hypothalamic- pituitary axis. In the follicular phase,RU-486 delays ovulation and disrupts folliculogenesis.

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