OBJECTIVE: Our purpose was to test the hypothesis that omitting the first three pills of the contraceptive cycle leads to ovulation. STUDY DESIGN:Ninety-nine women, randomly assigned to 1 of 3 treatments of combined oral contraceptives, completed the study. Treatments contained ethinyl estradiol and either monophasic gestodene, triphasic gestodene, or monophasic desogestrel. Pituitary-ovarian activity was monitored by ultrasonography of the ovaries and assay of serum concentrations of estradiol, progesterone, and follicle-stimulating hormone over 1 normal cycle (study period 1) and 1 cycle after an extended pill-free interval of 10 days (study period 2). RESULTS: None of the women experienced normal ovulation as evaluated by ultrasonography and serum progesterone concentrations. However, follicle-stimulating hormone reached a maximal serum concentration in most women during the first 7 pill-free days, indicating complete pituitary recovery, and increases in serum estradiol concentrations were seen in each woman although with marked interindividual variation. During study period 2 we found follicles of >18 mm in 24%, 24%, and 40% of the monophasic gestodene, triphasic gestodene, and monophasic desogestrel groups, respectively. CONCLUSIONS: Follicular growth up to preovulatory size is common in women missing the first one to three pills of their contraceptive cycle. Although this creates the prerequisite for ovulation, normal ovulation did not occur when pill omissions were limited to only 3 days.
RCT Entities:
OBJECTIVE: Our purpose was to test the hypothesis that omitting the first three pills of the contraceptive cycle leads to ovulation. STUDY DESIGN: Ninety-nine women, randomly assigned to 1 of 3 treatments of combined oral contraceptives, completed the study. Treatments contained ethinyl estradiol and either monophasic gestodene, triphasic gestodene, or monophasic desogestrel. Pituitary-ovarian activity was monitored by ultrasonography of the ovaries and assay of serum concentrations of estradiol, progesterone, and follicle-stimulating hormone over 1 normal cycle (study period 1) and 1 cycle after an extended pill-free interval of 10 days (study period 2). RESULTS: None of the women experienced normal ovulation as evaluated by ultrasonography and serum progesterone concentrations. However, follicle-stimulating hormone reached a maximal serum concentration in most women during the first 7 pill-free days, indicating complete pituitary recovery, and increases in serum estradiol concentrations were seen in each woman although with marked interindividual variation. During study period 2 we found follicles of >18 mm in 24%, 24%, and 40% of the monophasic gestodene, triphasic gestodene, and monophasic desogestrel groups, respectively. CONCLUSIONS: Follicular growth up to preovulatory size is common in women missing the first one to three pills of their contraceptive cycle. Although this creates the prerequisite for ovulation, normal ovulation did not occur when pill omissions were limited to only 3 days.
Entities:
Keywords:
Behavior; Belgium; Clinical Research; Contraception; Contraceptive Agents, Estrogen--administraction and dosage; Contraceptive Agents, Female--administraction and dosage; Contraceptive Agents, Progestin--administraction and dosage; Contraceptive Agents--administraction and dosage; Contraceptive Methods--administraction and dosage; Desogestrel--administraction and dosage; Developed Countries; Ethinyl Estradiol--administraction and dosage; Europe; Family Planning; Finland; Gestodene--administraction and dosage; Netherlands; Northern Europe; Oral Contraceptives, Combined--administraction and dosage; Oral Contraceptives--administraction and dosage; Ovulation; Reproduction; Research Methodology; Research Report; Scandinavia; User Compliance; Western Europe
Authors: Lauren B Zapata; Maria W Steenland; Dalia Brahmi; Polly A Marchbanks; Kathryn M Curtis Journal: Contraception Date: 2012-10-22 Impact factor: 3.375
Authors: Jennifer L Woods; Marcia L Shew; Wanzhu Tu; Susan Ofner; Mary A Ott; J Dennis Fortenberry Journal: J Adolesc Health Date: 2006-07-10 Impact factor: 5.012