Inhibition of ovulation by an oral contraceptive containing 100 μg levonorgestrel in combination with 20 μg ethinylestradiol

Spona, J; Feichtinger, Wilfried; Kindermann, C.; Wunsch, Charles M.; Brill, K.

doi:10.1016/s0010-7824(96)00183-7

Cited by 68 publications

(37 citation statements)

References 13 publications

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“…The number of subjects was 40 in the medication phase and is comparable with sample sizes used in other similar ovulation inhibition trials (7,8,22).…”

Section: Statistical Analysesmentioning

confidence: 66%

“…Grading was conducted according to a modified Hoogland and Skouby score (Table 1) (4)(5)(6)(7)(8). The Hoogland and Skouby score was determined for each cycle.…”

Section: Assessmentsmentioning

confidence: 99%

mentioning

confidence: 99%

“…To differentiate various levels of ovarian activity for comparison of different COCs, the grading system according to Hoogland and Skouby combines the ultrasonic examination of follicles with the determination of hormone levels (4)(5)(6)(7)(8). As evidenced by the development of follicle-like structures, residual ovarian activity was reported for several COCs (4)(5)(6)(7)(8). Thus, extending the active COC pill intake period to beyond 21 days and reducing the hormonefree interval were measures that were taken to reduce rebound effects of FSH and 17b-E 2 , maintaining the contraceptive efficacy and the tolerability in low-dose COCs (8)(9)(10)(11)(12).…”

mentioning

confidence: 99%

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Suppression of ovarian function by a combined oral contraceptive containing 0.02 mg ethinyl estradiol and 2 mg chlormadinone acetate given in a 24/4-day intake regimen over three cycles

Spona¹,

Binder

Höschen

et al. 2010

Fertility and Sterility

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“…The number of subjects was 40 in the medication phase and is comparable with sample sizes used in other similar ovulation inhibition trials (7,8,22).…”

Section: Statistical Analysesmentioning

confidence: 66%

“…Grading was conducted according to a modified Hoogland and Skouby score (Table 1) (4)(5)(6)(7)(8). The Hoogland and Skouby score was determined for each cycle.…”

Section: Assessmentsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Suppression of ovarian function by a combined oral contraceptive containing 0.02 mg ethinyl estradiol and 2 mg chlormadinone acetate given in a 24/4-day intake regimen over three cycles

Spona¹,

Binder

Höschen

et al. 2010

Fertility and Sterility

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“…Se encontraron 18 trabajos (10-27) en que se analizaba la actividad ovárica -específicamente la ovulación-en la utilización de microdosis de ACO monofásicos combinados continuos de los cuales se eligieron 3 trabajos experimentales (25)(26)(27) que eran comparables entre ellos según los siguientes criterios de inclusión: 1) población semejante en cuanto a edad (18-35 años) y antecedentes ginecológicos: 2) número de ciclos analizados (5: 1 pretratamiento, 3 en tratamiento y 1 post-tratamiento); 3) el método para determinar la ovulación en todos los ciclos: ecografía transabdominal o transvaginal, y análisis hormonal de muestras de sangre (FSH, LH, 17 β estradiol y progesterona). También se consideró el hecho de que todos fuesen ACO de bajas dosis de EE2 (20 µg de etinilestradiol) asociados a levenorgestrel, desogestrel o a gestodene.…”

Section: Materials Y Metodounclassified

Mecanismo De Accion De Anticonceptivos Orales: ¿cumplen Los Aco De Bajas Dosis Con El Objetivo De Inhibir La Ovulacion?

C.¹,

Preisler²,

Poli³

2002

Rev. chil. obstet. ginecol.

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RESUMENLa inhibición de la ovulación es el principal mecanismo o efecto buscando en los casos de utilización terapéutica o contraceptiva de los anticonceptivos orales (ACO). Los mecanismos de acción secundarios postfertilización tienen reparos éticos para aquellas pacientes que consideran la concepción como el comienzo del desarrollo de la persona humana. Quisimos saber en qué medida se inhibe la ovulación mediante la administración de ACO de bajas dosis, como primera aproximación al problema ético planteado por los efectos postfertilización y para analizar la eficacia terapéutica de los anticonceptivos orales. Se revisa la literatura entre los años 1985 y 2001 y se seleccionan tres trabajos comparables entre sí de los cuales se desprenden los resultados. En un período de seguimiento de tres meses, las mujeres que ingieren en forma adecuada ACO monofásicos combinados de bajas dosis que contienen 20 µg de etinilestradiol, presentan ovulación demostrada hormonal y ecográficamente en 2,35% a 8,3% de las mujeres. Existe una tendencia al aumento de la actividad ovárica y de los diámetros foliculares a medida que transcurre el tiempo de observación. Si el objetivo terapéutico es la anovulación, estas cifras permiten considerar los ACO como terapias adecuadas. Frente a la utilización individual de los ACO en contracepción, las cifras expuestas permitirán abordar en qué medida actúan los mecanismos secundarios y así considerar parámetros más objetivos en el análisis de los aspectos éticos a evaluar por el médico y la paciente. PALABRAS CLAVES: Anticonceptivos de bajas dosis SUMMARYOral contraceptives (OCs) may be used for therapeutic or family planning purposes. Inhibition of ovulation is the main mechanism implicated in both instances, though post-fertilization effects described as secondary mechanism in effective contraception are ethically unacceptable for some patients who identify the start of human person at fertilization. Our concern was to establish the anovulatory power of low dose OCs in attempting to answer the ethical question and secondarily to evaluate their therapeutic efficacy. Literature search of articles published from 1985 through december 2001 using Medline concluded with 15 articles (meaningful to this theme) who met inclusion criteria: low dose monophasic preparation containing 0.20 mg ethinylestradiol, ovulation assessed by means of hormonal and transvaginal ultrasound monitoring and the trial carried out over a period of at least three treatment cycles. Three studies are analized. We conclude that in 2.35% to 8% of women, ovulation was confirmed.This results indicate that low-dose

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Drug‐Drug Interaction Studies With Oral Contraceptives: Pharmacokinetic/Pharmacodynamic and Study Design Considerations

Sun

Sivasubramanian

Vaidya

et al. 2020

The Journal of Clinical Pharma

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Oral contraceptives (OCs) are the most widely used form of birth control among women of childbearing potential. Knowledge of potential drug‐drug interactions (DDIs) with OCs becomes imperative to provide information on the medication to women of childbearing potential and enable their inclusion in clinical trials, especially if the new molecular entity is a teratogen. Although a number of DDI guidance documents are available, they do not provide recommendations for the design and conduct of OC DDI studies. The evaluation of DDI potential of a new molecular entity and OCs is particularly challenging because of the availability of a wide variety of combinations of hormonal contraceptives, different doses of the ethinyl estradiol, and different metabolic profiles of the progestin component. The aim of this review is to comprehensively discuss factors to be considered such as pharmacokinetics (PK), pharmacodynamics (PD), choice of OC, and study population for the conduct of in vivo OC DDI studies. In this context, metabolic pathways of OCs, the effect of enzyme inhibitors and inducers, the role of sex hormone–binding globulin in the PK of progestins, current evidence on OC DDIs, and the interpretation of PD end points are reviewed. With the emergence of new tools like physiologically based PK modeling, the decision to conduct an in vivo study can be made with much more confidence. This review provides a comprehensive overview of various factors that need to be considered in designing OC DDI studies and recommends PK‐based DDI studies with PK end points as adequate measures to establish clinical drug interaction and measurement of PD end points when there is basis for PD interaction.

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Inhibition of ovulation by an oral contraceptive containing 100 μg levonorgestrel in combination with 20 μg ethinylestradiol

Cited by 68 publications

References 13 publications

Suppression of ovarian function by a combined oral contraceptive containing 0.02 mg ethinyl estradiol and 2 mg chlormadinone acetate given in a 24/4-day intake regimen over three cycles

Suppression of ovarian function by a combined oral contraceptive containing 0.02 mg ethinyl estradiol and 2 mg chlormadinone acetate given in a 24/4-day intake regimen over three cycles

Mecanismo De Accion De Anticonceptivos Orales: ¿cumplen Los Aco De Bajas Dosis Con El Objetivo De Inhibir La Ovulacion?

Drug‐Drug Interaction Studies With Oral Contraceptives: Pharmacokinetic/Pharmacodynamic and Study Design Considerations

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