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Oral contraceptive type and functional ovarian cysts
254
Citations from the Literature
OraI contraceptive
type and fanctional ovarian cysts Lanes SF, Birmann B; Walker AM; Singer S Epidemiology Resources Inc., One Newton Executive Park, Newton, MA 02162, USA
AM J OBSTET GYNECOL 1992 16613(956-961) Objective: We tested the hypothesis that multiphasic, lowdose monophasic and high-dose monophasic oral contraceptives share a common protective effect against functional ovarian cysts. Study Design: We conducted a cohort study using the automatic files of Maine Medicaid to assemble a population of 7462 women between the ages of 15 and 44 who were prescribed an oral contraceptive between Jan. 1, 1987 and Dee. 31, 1988. We included as cases 32 women with a principal diagnosis of a functional ovarian cyst confirmed by medical records as being > 20 mm in diameter. Results: At comparison with the absence of an oral contraceptive prescription, we observed decreasing rates of functional ovarian cysts among women prescribed multiphasic pills (rate ratio 0.91, 95% confidence interval 0.3000 to 2.31), low-dose monophasic pills with s 35 cg estrogen (rate ratio 0.52, 95% > 35 pg estrogen (rate ratio 0.24, 95% confidence interval 0.01 to 1.34). Conclusions: The protective effect of oral contraceptives against functional ovarian cysts reported previously for high-dose monophasic pills may be attenuated with newer pills of lower hormonal Comparisonof tramdermal and oral estrogen-progestinreplacement therapy: Effects on serum lipids and lipoproteins Crook D; Cust MP; Gangar KF; Worthington M; Hillard TC; Stevenson JC; Whitehead MI; Wynn V Wynn Institute for Metabolic Research, 21 Wellington Road. London NW8 9SQ, GBR
AM J OBSTET GYNECOL 1992 166/3 (950-955) Objective: We attempted to ascertain whether transdermal postmenopausal estrogen-progestin therapy has the typical effects of oral therapy on serum lipoprotein risk markers for cardiovascular disease. Study design: Sixty-one postmenopausal women were randomized to receive either transdermal continuous 17&estradiol, 0.05 mgday, with transdermal cyclic norethindrone acetate, 0.25 mgday, or oral continuous conjugated equine estrogens, 0.625 mg/day, with oral cyclic dl-norgestrel, 0.15 mg/day. Twenty-nine untreated subjects served as controls. Lipoprotein profiles at 3 and 6 months were compared with baseline values by means of analysis of variance. Results: In the estrogen-alone phase both therapies reduced serum levels of total and low-density lipoprotein cholesterol; high-density lipoproteins were largely unchanged. Oral therapy increased triglycerides whereas this lipid fell with transdermal therapy. In the combined phase of the cycle both therapies reduced triglycerides, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Conclusion: Transdermal and oral therapies had similar effects on lipoprotein cholesterol but different effects on triglycerides. Contraceptive compliance with a levonorgestrel triphasic and a norethindrone monophasic oral contraceptive in adolescent patients Woods ER; Grace E; Klein Havens K, Merola JL; Emans SJ Int J Gynecol Obstet 39
Division of Adolescent/Young Adult Hospital, Boston, MA 02115. USA
Medicine,
Children’s
AM J OBSTET GYNECOL 1992 16613(901-907) Objective: This study was undertaken to assess the impact of two low-dose oral contraceptive pills on compliance and side effects in adolescent patients. Study design: The use of a levonorgestrel-containing triphasic pill (N = 114) was compared with that of a monophasic (1 + 35) norethindronecontaining pill (N = 110) at two different sociodemographic sites. Results: No significant difference in compliance or pill satisfaction was observed between the pills. Socioeconomic factors were the overriding predictors of compliance. At 3 and 12 months of follow-up, there were significantly fewer compliants of overall side effects (P < 0.001 and P = 0.004, respectively), breakthrough bleeding (P= 0.017 and P= 0.018) and pill amenorrhea (P = 0.002 and P < 0.001) among users of the triphasic pill. Mean weight change at 12 months was +l.l kg for the monophasic pill and -0.1 kg for the triphasic pill. All known pregnancies occurred among noncompliant city clinic patients. Conclusions: Adolescents experienced fewer side effects with the triphasic pill than with the monophasic one, but compliance was the same.
FERTILITY, STERILITY Immunosuppressiveactivity and alpha interferon concentrations in human embryo culture media as an index of potential for SUCcessfal implantation Jones KP; Wamock SH; Urry RL; Edwin SS; Mitchell MD USA
FERTIL STERIL 1992 5713 (637-640) Objective: To evaluate potential correlations between establishment of pregnancy and immunosuppressive activity secreted by the preimplantation embryo. Design: To evaluate immunosuppressive activity, supematants from preimplantation embryos were assessed for their ability to inhibit lymphocyte proliferation. Additionally, alpha interferon concentrations were also measured in these supernatants. We compared these parameters from embryo culture supematants of women who did and did not achieve pregnancy after in vitro fertilization (IVF). Immunosuppression was assessed using a lymphocyte proliferation assay with concanavalin A (Con A) and phytohemagglutinin (PHA) as mitogens. Setting: In vitro fertilization program at the University of Utah Medical Center. Participants: Couples < 40 years of age, with normal semen quality and bilateral tubal obstruction. Results: Immunosuppression calculated using the stimulation index (mean, * SEM) in pregnant and nonpregnant women, respectively, were: Con A: 43.9 f 3.9 versus 19.1 f 10.1, P < 0.04. PHA: 23.6 f 5.6 versus 12.5 ?? 12.8, P < 0.02. Alpha interferon levels (mean f SD) in pregnant and nonpregnant women were not significantly different: 23.98 f 9.6 units/ml versus 24.79 + 2.5 units/ml. Conclusions: We conclude that pre-embryos with the capacity for successful implantation secrete greater amounts of immunosuppressive factors than those destined not to implant, as measured by Con A and PHA lymphocyte proliferation assays. Refinement of assay techniques and identification of the substances involved could have a significant impact on IVF programs.
Citations from the Literature
OraI contraceptive
type and fanctional ovarian cysts Lanes SF, Birmann B; Walker AM; Singer S Epidemiology Resources Inc., One Newton Executive Park, Newton, MA 02162, USA
AM J OBSTET GYNECOL 1992 16613(956-961) Objective: We tested the hypothesis that multiphasic, lowdose monophasic and high-dose monophasic oral contraceptives share a common protective effect against functional ovarian cysts. Study Design: We conducted a cohort study using the automatic files of Maine Medicaid to assemble a population of 7462 women between the ages of 15 and 44 who were prescribed an oral contraceptive between Jan. 1, 1987 and Dee. 31, 1988. We included as cases 32 women with a principal diagnosis of a functional ovarian cyst confirmed by medical records as being > 20 mm in diameter. Results: At comparison with the absence of an oral contraceptive prescription, we observed decreasing rates of functional ovarian cysts among women prescribed multiphasic pills (rate ratio 0.91, 95% confidence interval 0.3000 to 2.31), low-dose monophasic pills with s 35 cg estrogen (rate ratio 0.52, 95% > 35 pg estrogen (rate ratio 0.24, 95% confidence interval 0.01 to 1.34). Conclusions: The protective effect of oral contraceptives against functional ovarian cysts reported previously for high-dose monophasic pills may be attenuated with newer pills of lower hormonal Comparisonof tramdermal and oral estrogen-progestinreplacement therapy: Effects on serum lipids and lipoproteins Crook D; Cust MP; Gangar KF; Worthington M; Hillard TC; Stevenson JC; Whitehead MI; Wynn V Wynn Institute for Metabolic Research, 21 Wellington Road. London NW8 9SQ, GBR
AM J OBSTET GYNECOL 1992 166/3 (950-955) Objective: We attempted to ascertain whether transdermal postmenopausal estrogen-progestin therapy has the typical effects of oral therapy on serum lipoprotein risk markers for cardiovascular disease. Study design: Sixty-one postmenopausal women were randomized to receive either transdermal continuous 17&estradiol, 0.05 mgday, with transdermal cyclic norethindrone acetate, 0.25 mgday, or oral continuous conjugated equine estrogens, 0.625 mg/day, with oral cyclic dl-norgestrel, 0.15 mg/day. Twenty-nine untreated subjects served as controls. Lipoprotein profiles at 3 and 6 months were compared with baseline values by means of analysis of variance. Results: In the estrogen-alone phase both therapies reduced serum levels of total and low-density lipoprotein cholesterol; high-density lipoproteins were largely unchanged. Oral therapy increased triglycerides whereas this lipid fell with transdermal therapy. In the combined phase of the cycle both therapies reduced triglycerides, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Conclusion: Transdermal and oral therapies had similar effects on lipoprotein cholesterol but different effects on triglycerides. Contraceptive compliance with a levonorgestrel triphasic and a norethindrone monophasic oral contraceptive in adolescent patients Woods ER; Grace E; Klein Havens K, Merola JL; Emans SJ Int J Gynecol Obstet 39
Division of Adolescent/Young Adult Hospital, Boston, MA 02115. USA
Medicine,
Children’s
AM J OBSTET GYNECOL 1992 16613(901-907) Objective: This study was undertaken to assess the impact of two low-dose oral contraceptive pills on compliance and side effects in adolescent patients. Study design: The use of a levonorgestrel-containing triphasic pill (N = 114) was compared with that of a monophasic (1 + 35) norethindronecontaining pill (N = 110) at two different sociodemographic sites. Results: No significant difference in compliance or pill satisfaction was observed between the pills. Socioeconomic factors were the overriding predictors of compliance. At 3 and 12 months of follow-up, there were significantly fewer compliants of overall side effects (P < 0.001 and P = 0.004, respectively), breakthrough bleeding (P= 0.017 and P= 0.018) and pill amenorrhea (P = 0.002 and P < 0.001) among users of the triphasic pill. Mean weight change at 12 months was +l.l kg for the monophasic pill and -0.1 kg for the triphasic pill. All known pregnancies occurred among noncompliant city clinic patients. Conclusions: Adolescents experienced fewer side effects with the triphasic pill than with the monophasic one, but compliance was the same.
FERTILITY, STERILITY Immunosuppressiveactivity and alpha interferon concentrations in human embryo culture media as an index of potential for SUCcessfal implantation Jones KP; Wamock SH; Urry RL; Edwin SS; Mitchell MD USA
FERTIL STERIL 1992 5713 (637-640) Objective: To evaluate potential correlations between establishment of pregnancy and immunosuppressive activity secreted by the preimplantation embryo. Design: To evaluate immunosuppressive activity, supematants from preimplantation embryos were assessed for their ability to inhibit lymphocyte proliferation. Additionally, alpha interferon concentrations were also measured in these supernatants. We compared these parameters from embryo culture supematants of women who did and did not achieve pregnancy after in vitro fertilization (IVF). Immunosuppression was assessed using a lymphocyte proliferation assay with concanavalin A (Con A) and phytohemagglutinin (PHA) as mitogens. Setting: In vitro fertilization program at the University of Utah Medical Center. Participants: Couples < 40 years of age, with normal semen quality and bilateral tubal obstruction. Results: Immunosuppression calculated using the stimulation index (mean, * SEM) in pregnant and nonpregnant women, respectively, were: Con A: 43.9 f 3.9 versus 19.1 f 10.1, P < 0.04. PHA: 23.6 f 5.6 versus 12.5 ?? 12.8, P < 0.02. Alpha interferon levels (mean f SD) in pregnant and nonpregnant women were not significantly different: 23.98 f 9.6 units/ml versus 24.79 + 2.5 units/ml. Conclusions: We conclude that pre-embryos with the capacity for successful implantation secrete greater amounts of immunosuppressive factors than those destined not to implant, as measured by Con A and PHA lymphocyte proliferation assays. Refinement of assay techniques and identification of the substances involved could have a significant impact on IVF programs.