Comparison of effects of levonorgestrel-releasing intrauterine devices and Cu-T 380A intrauterine devices on ovarian functions

Year 2012, Volume: 29 Issue: 1, 13 - 16, 17.04.2012

Haldun Arpacı , Deniz Arıkan , Emel Kurtoğlu

https://doi.org/10.5835/jecm.omu.29.01.004

Abstract

Our aim was to compare the effects of levonorgestrel-releasing intrauterine devices (LNG-IUD) and Cu-T380 A IUDs on ovarian functions. We included 73 volunteer women aged between 20 and 35 who attended Kahramanmaras Sutcu Imam University Gynecology and Obstetrics Policlinic for contraception requests, as well as a control group of 22 vol¬unteer women aged between 20 and 35 who attended the clinic and had regular menstrual cycles and no gynecologic problems. The cases were separated into two groups: 38 pa¬tients with LNG-IUD inserted and 35 patients with Cu-T380 A IUD inserted. The patients were invited for controls on the 10th, 12th, 14th, and 21st days of their cycles in the first, second, and third months after IUD insertion. In the control visits, follicular development, follicle-stimulating hormone, luteinizing hormone, oestrogen and progesterone levels were measured. During the three monthly follow-ups of all patients, there were significant differences between ovarian function types (p=0.03). D type ovarian reaction rate was significantly lower in the LNG-IUD group (11.5% vs. 19.0%, p<0.05) and maximal size of follicles were significantly lower in the group using the LNG-IUD (p<0.05).The LNG-IUD was found to have an inhibitory effect on ovulation, which seems to increase its contraceptive effect. 

Keywords

Contraception, LNG-IUD (Mirena), Cu-T380 A IUD, Ovulation, FSH, LH

References

• Akın, A., 2008. Aile Planlamasi [Family planning] In: Temel Kadin Hastaliklari ve Dogum Bilgisi (The Basic Gynecology and Obstetrics). 109-135.
• Barbosa, I., Bakos, O., Olsson, S.E., Odlind, V., Johansson, E.D., 1990. Ovarian function during use of a levonorgestrel-releasing I.U.D. Contraception. 42, 51-66.
• Barbosa, I., Olsson, S.E., Olind, V., Goncalves, T., Coutinho, E., 1995. Ovarian function after seven years’ use of a levonorgestrel I.U.D. Adv. Contracept. 11, 85-95.
• Brenner, P.F., Mishell, D.R.Jr., 1975. Progesterone and estradiol patterns in women using an intrauterine contraceptive device. Obstet. Gynecol. 46, 456-459.
• Critchley, H.O.D., Wang, H., Kelly, R.W., Gebbie, A.E., Glasier, F.A., 1998. Progestin receptor isoforms and prostoglandine dehydrogenase in the endometrium of women using a levonorgestrel intrauterine device. Human Reprod. 13, 1210-1217.
• Ecochard, R., Marret, H., Rabilloud, M., Bradai, R., Boehringer, H., Girott, S., Barbato, M.., 2000. Sensitivity and specificity of ultrasound indices of ovulation in spontaneous cycles. Eur. J. Obstet. Gynecol. Reprod. Bio. 91, 59–64.
• Fortergill, D.J., Brown, V.A., Hill, A.S., 1982. Histological sampling of the endometrium-a comparison between formal curretage and pipelle sample. Br. J. Obstet. Gynecol. 99, 779-780.
• Grewal, M., Burkman, R.T., 2003. Contraception and family planning. In: Current Obstetric and Gynecologic Diagnosis and Treatment. 631- 650.
• Guillebaud, J., 2003. The levonorgestrel intrauterine system: A clinical perspective from the U.K. Ann. N.Y. Acad. Sci. 997, 185-193.
• Jarvela, I., Tekay, A., Jouppila, P., 1998. The effect of a levonorgestrel intrauterine device on uterine artery blood flow, hormone concentrations and ovarian cyst formation in fertil women. Human Reprod. 13, 3379-3383.
• Lahteenmaki, P., Allonen, H., Kulmala, Y., 1991. Endocervical cytological smear abnormalities (Papanicolaou class 3-4) during use of levonorgestrel intrauterin device and copper intrauterin device (Nova-T). Leiaras Study Report. 1206-1209.
• Landren, B.M., Diczfaluzy, E., 1980. Hormonal effects of the 300 mcg norethisterone (NET) minipill.1.Daily steroid levels in 43 subjects during a pretreatment cycle and during the second month of NET administration. Contraception. 21, 87-113.
• Leader, A., Wiseman, D., Taylor, P.J., 1985. The prediction of ovulation: Comparison of the basal body temperature graph, cervical mucus score, and real-time pelvic ultrasonography. Fertil Steril. 43, 385–388.
• Lenz, S., 1985.Ultrasonic study of follicular maturation, ovulation and development of corpus luteum during normal menstrual cycles. Acta. Obstet. Gynecol. Scand. 64, 15–19.
• Luukkainen, T., Lâhteenmâki, P., Toivonen, J., 1990. Levonorgestrel-releasing intrauterine device. Ann. Med. 22, 85-90.
• Maruo, T., Laoag-Fernandez, J.B., Matsuo, H., Spitz, I.M., Johansson, E., 2001. Effects of levonorgestrel-releasing intrauterine system on proliferation and apoptosis in the endometrium. Hum. Reprod. 16, 2103-2108.
• Maruo, T., Laoag-Fernandez, J.B., Matsuo, H., 2001. Effects of levonorgestrel-releasing intrauterine system on the endometrium and the relevance to the management of menorrhagia caused by uterine leiomyoma and adenomyosis. In : Cell and Molecular Biology of endometrium in Health and Disease. Maruo, T., Barlow, D., Mardon, H., Kennedy, S., eds. Osaka, Japan, pp. 193-207.
• Nelson, A.L., 2000. The intrauterine contraceptive device. Obstet. Gynecol. Clin. North. Am. 27, 723-740.
• Nilsson, C.G., Lahteenmaki, P.L., Luukkainen, T., 1984. Ovarian function in amenorrheic and menstruating users of a levonorgestrel- releasing intrauterine device. Fertil. Steril. 41, 52-55.
• Phillip, G., Stubblefield, Sacheen C.E., Kapp, N., 2007. Family planning in: Berek and Novak’s Gynecology, 14 Th edition, Jonathan S. Berek eds. Lippincott Williams and Wilkins, Philadelphia. 261.
• Turin, E.M., Nagle, C.A., Lahoz, M., Torres, M., Mendizabal, A.F., Escofet, M.B., 1997. Effects of a copper-bearing intrauterin device on the ovarian function, body weight gain and pregnancy rate of nulliparous heifers. Theriogenology. 47, 1327-1336.
• Xiao, B.L., Zhou, L.Y., Zhang, X.L., Jia, M.C., Luukkainen, T., Allonen, H., 1990. Pharmacokinetic and pharmacodynamic studies of levonorgestrel-releasing intrauterine device. Contraception. 41, 353-362.