[Show abstract][Hide abstract] ABSTRACT: Unintended pregnancy is a global reproductive health problem. Emergency contraception (EC) provides women with a safe means of preventing unwanted pregnancies after having unprotected intercourse. While 1.5 mg of levonorgestrel (LNG) as a single dose or in 2 doses with 12 hours apart is the currently gold standard EC regimen, a single dose of 30 mg ulipristal acetate (UPA) has recently been proposed for EC use up to 120 hours of unprotected intercourse with similar side effect profiles as LNG. The main mechanism of action of both LNG and UPA for EC is delaying or inhibiting ovulation. However, the 'window of effect' for LNG EC seems to be rather narrow, beginning after selection of the dominant follicular and ending when luteinizing hormone peak begins to rise, whereas UPA appears to have a direct inhibitory effect on follicular rupture which allows it to be also effective even when administered shortly before ovulation, a time period when use of LNG is no longer effective. These experimental findings are in line with results from a series of clinical trials conducted recently which demonstrate that UPA seems to have higher EC efficacy compared to LNG. This review summarizes some of the data available on UPA used after unprotected intercourse with the purpose to provide evidence that UPA, a new type of second-generation progesterone receptor modulator, represents a new evolutionary step in EC treatment.
Preview · Article · Aug 2010 · International Journal of Women's Health
[Show abstract][Hide abstract] ABSTRACT: Objective
To analyze the possible cause leading to death during the procedure of IUD removal under hysteroscopy and how it could be prevented.
All (11 110) cases of IUD removal under hysteroscopy performed at 87 hospitals in Shanghai from 2001 to 2007 were reviewed. Four dead cases were reported.
Air embolism was suspected as the cause of death. Associated risk factors included insufficient preoperative preparation, short duration between surgeries, non-standard procedure, careless observation and untimely resuscitation.
This emphasizes the necessity of early interventions taken such as prevention, early detection and management of the fatal complications.
No preview · Article · Jun 2010 · Journal of Reproduction and Contraception
[Show abstract][Hide abstract] ABSTRACT: Levonorgestrel (1.5 mg) is commonly used for emergency contraception to prevent an unwanted pregnancy after an unprotected intercourse. We found that postovulatory administration of 1.5 mg of levonorgestrel to women with a subsequent or existing early pregnancy did not affect the immunohistochemical expressions of estrogen receptors (ER., ER,3), P receptors (PR(B), PR(A+B)), androgen receptor (AR), or proliferation index Ki67 in the first-trimester decidua and chorionic villi. (Fertil Steril (R) 2009;91:1420-3. (C) 2009 by American Society for Reproductive Medicine.)
No preview · Article · Sep 2008 · Fertility and sterility
[Show abstract][Hide abstract] ABSTRACT: To investigate the effect of levonorgestrel and mifepristone on the expression of endometrial receptivity markers in a three-dimensional endometrial construct.
In vitro study.
University hospital and research laboratory.
Twelve fertile donors.
Timed endometrial biopsy.
Examine the effect of levonorgestrel along with another well-studied fertility-regulating drug, mifepristone, on the expression of endometrial receptivity factors in a three-dimensional stromal and epithelial cell coculture model by immunohistochemistry.
Both epithelial and stromal cells of in vitro endometrial construct showed the presence of estrogen receptor-alpha, estrogen receptor-beta, progesterone receptors-(A+B), vascular endothelial growth factor, leukemia inhibitory factor, interleukin-1 beta, and cyclooxygenase-2, whereas the expression of progesterone receptor-B (AR), integrin alpha(V)beta(3,) and MUC1 were confined to epithelial cells. Mifepristone up-regulated expression of epithelial estrogen receptor-beta and progesterone receptor-B and down-regulated stromal vascular endothelial growth factor and surface molecules MUC1 and integrin alpha(V)beta(3) as observed in vivo. Levonorgestrel had no effect on the expression of endometrial receptivity markers studied.
This in vitro model expresses progesterone-regulated endometrial receptivity factors seen in the physiologic condition. Treatment with levonorgestrel did not affect the expression of these endometrial receptivity markers in contrast to mifepristone. This in vitro model holds the potential to study endometrial receptivity, the embryo-endometrial interaction, and develop new agents for fertility control.
No preview · Article · Feb 2008 · Fertility and sterility