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Contraception. 1996 Nov;54(5):271-3.

Ovarian activity during regular oral contraceptive use.

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1
Prima Clinica Ostetrico Ginecologica, Università di Milano, Italy.

Abstract

The aim of this study was to assess whether during regular OC use ovarian activity might lead to ovulation, as assessed by ultrasound (US) evaluation of follicular growth and blood levels of 17-beta-estradiol and progesterone. A total of 51 healthy women with normal menstrual cycles (28 +/- 3 days) and no gynecological symptoms were recruited. A total of 22 patients were given a triphasic OC pill containing 35 mg ethinyl estradiol (EE) and 50 mg desogestrel (DSG) in the first seven tablets; 30 mg EE and 100 mg DSG in tablets 8 to 14, and 30 mg EE and 150 mg DSG in tablets 15 to 21; 29 patients received one of two OC pills, both containing 20 mg EE plus 150 mg DSG (15 patients) or 75 mg of gestodene (14 patients). A total of 86 cycles were monitored: 51 during the 3rd-4th cycle and 35 during the 6th-8th cycle of OC treatment. Follicular-like structures were observed in nine patients. The frequency of follicular-like structures was similar during the 3rd-4th cycle (9%) and during the 6th-8th cycle (11%). There was no relationship between follicular growth and blood levels of E2 and progesterone, which always appeared suppressed. In conclusion, the results of this study suggest that during OC use (even with low dose of ethinyl estradiol), a little ovarian activity may be present without ovulation.

PIP:

Several studies have described a 10-20% incidence of folliculogenesis during low-dose oral contraceptive (OC) use. This study used ultrasound evaluation of follicular growth and blood levels of 17-beta-estradiol and progesterone to determine whether OC-induced ovarian activity led to ovulation in 51 healthy women with regular menstrual cycles. Subjects were given a new triphasic OC containing 35 mg ethinyl estradiol (EE) and 50 mg desogestrel (DSG) in the first 7 tablets, 30 mg EE and 100 mg DSG in tablets 8-14, and 30 mg EE and 150 mg DSG in tablets 15-21 (22 women); an OC containing 20 mg EE and 150 mg DSG (15 women); or an OC comprised of 20 mg EE and 75 mg gestodene (14 women). A total of 86 cycles were monitored: 51 during the third and fourth cycles and 35 during the sixth through eighth cycles of treatment. Follicular-like structures were observed in 9 patients. Follicular growth occurred in 4 cycles (11%) in the triphasic group, 3 (13%) in the EE-DSG group, and 2 (7%) in the EE-gestodene group. The frequency of follicular-like structures was similar during the third-fourth cycle (9%) and the sixth-eighth cycle (11%). There was no association between follicular growth and blood levels of estradiol and progesterone. These results are compromised by the fact that only 35 of the 51 subjects completed 2 cycles. Nonetheless, they tend to confirm the observation that even a low dose of ethinyl estradiol can produce some ovarian activity without ovulation.

PMID:
8934059
[Indexed for MEDLINE]
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