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PubMed1988

Debrisoquine oxidation in a Finnish population: the effect of oral contraceptives on the metabolic ratio.

1. The debrisoquine hydroxylation phenotype was assessed in 211 healthy subjects of Finnish Caucasian origin. 2. A bimodal distribution was observed in the urinary debrisoquine/4-hydroxydebrisoquin ratio. Eleven subjects (about 5%) were poor metabolizers of debrisoquine, when a ratio of 12.6 was used as the cut-off point. 3. The mean metabolic ratio of 35 extensive metabolizers taking oral contraceptives was slightly lower than that of extensive metabolizers not taking contraceptives. This indicates that oral contraceptives may change the phenotyping near the metabolic ratio of 12.6. 4. The metabolic ratios were determined in eight subjects using both 4 h and 6 h urine collection times. The metabolic ratios corresponded well with each other indicating the usefulness of the shorter 4 h collection time.

Adult↗
PubMed2003

PON1-192 phenotype and genotype assessments in 918 subjects of the Stanislas cohort study.

This study describes the factors of variation of the enzymes related to the PON1-192 phenotype assessment, i.e., basal paraoxonase, salt-stimulated paraoxonase and arylesterase activities, and compares the PON1-192 phenotype to the PON1-192 genotype assessments in supposedly healthy subjects issued from the Stanislas cohort study. The studied population included 918 subjects, i.e., 221 families including 441 adults and 477 children aged 4 to 58 years. Potential determinants such as age, gender, body mass index, alcohol and tobacco consumption, and oral contraceptive intake have been studied. The PON ratio (salt-stimulated paraoxonase/arylesterase) was trimodally distributed and the cut-off values used to differentiate the two homozygous (AA and BB phenotypes) from the heterozygous (AB phenotype) subjects were 3.0 and 7.0 in this study. In males, basal paraoxonase and salt-stimulated paraoxonase activities were not affected by alcohol consumption and current smoking, but basal paraoxonase activity was decreased by 15% by current smoking and was increased by 15% by oral contraceptive intake in females as was the salt-stimulated paraoxonase activity. The level of discordance between phenotype and genotype assessments was 7.2% (66/918). Most of the discrepancies were observed between the BB and AB phenotypes (4.25%).

Adolescent↗
PubMed2000

Minimal stimulation IVF using clomiphene citrate and oral contraceptive pill pretreatment for LH suppression.

OBJECTIVE: To determine if oral contraceptive pill (OC) pre-treatment prior to minimal stimulation IVF using clomiphene citrate (CC) would make the procedure easier to perform by preventing the LH surge and result in pregnancy rates (PRs) comparable to stimulated IVF. DESIGN: Prospective cohort study. SETTING: Private tertiary infertility center. PATIENT(S): Thirty-two women with tubal or pelvic adhesive disease as the cause of their infertility, ovulatory cycles, under the age of 40, and no male factor. INTERVENTION(S): Two-month ovarian-hypothalamic-pituitary axis suppression with OC followed by CC 100 mg on day 3 of the cycle for 8 days, hCG administration midcycle, follicle aspiration, IVF, and embryo transfer. MAIN OUTCOME MEASURE(S): Oocytes retrieved, serum LH and estradiol levels, maturity of oocytes, fertilization rates, embryo number and quality, and PRs. RESULT(S): Thirty-six patients completed 71 stimulation cycles and 64 follicle aspirations. No LH surges occurred with a mean mature oocytes retrieved of 3.2, 90% fertilization rate, and mean 2.5 embryos transferred. Twenty-one of the 64 cycles resulted in a clinical pregnancy (32.8% PR per retrieval) with 2 other biochemical pregnancies and 3 twin gestations. This was not significantly different from the matched cohort stimulated IVF. CONCLUSION(S): Minimal stimulation IVF is a simple, low-cost, and low-risk alternative to stimulated IVF with comparable PRs.

Adult↗
PubMed1981

Fertility decline and differences in less-developed countries: an anthropological microstudy of some communities of West Bengal, India and Upper Khumbu, Nepal.

The role of socioeconomic and other cultural factors as determinants of fertility change has been widely discussed, with some scholars emphasising an inverse relation between socioeconomic development and fertility, others suggesting that no such relation necessarily exists, and yet others indicating that by using data from various sources it is possible to "prove" that a given country's crude birth rate has declined, remained unchanged or increased. Demographic data are presented on age-sex structure, completed and total fertility rates, and age specific fertility rates by age cohorts of women, from several small, anthropological population units of West Bengal, India and Upper Khumbu, Nepal, exposed to various physical and cultural environmental stresses. The data show that fertility has declined in most of the populations/subpopulations studied and that the decline may, deductively, be attributed to economic development via greater family planning practices.

Adolescent↗
PubMed1984

Hepatocellular carcinoma in the non-cirrhotic liver: a comparison with that complicating cirrhosis.

The clinicopathological features of 50 patients with hepatocellular carcinoma arising in a non-cirrhotic liver are described and compared with those of 100 patients in whom the tumour arose as a complication of cirrhosis. The non-cirrhotic patients were significantly younger, more often female and had a less strong association with serum markers of hepatitis B virus infection. Liver function tests and serum AFP were less often abnormal and survival was significantly better than in the cirrhotic group. The different aetiological factors, clinical features and prognosis of hepatocellular carcinoma arising in the non-cirrhotic liver compared to the more common form of hepatocellular carcinoma which complicates cirrhosis justifies detailed investigation by liver biopsy and other techniques.

Adolescent↗
PubMed1996

[Use of contraception and reasons for choosing abortion among abortion applicants].

The object of this study was to describe a group of women applying for legal abortion in relation to their use of contraception and reasons for choosing an abortion. During a period of 13 months (1991-92) a questionnaire was distributed to women applying for legal abortion at Hillerød Hospital in Denmark. Three hundred and thirty-nine women participated. Fifty-nine percent of the women had become pregnant although they had used contraception. As seen in other studies, women still state demographic factors as their most important reasons for choosing an abortion. Women with two or more children do not want to have more children. Single women do not want children without being in a stable relationship. Furthermore occupation and education were frequently stated as important reasons for having an abortion. Economy and housing were not main reasons but contributory factors. Thirty percent of the women expressed ambivalence about the choice of abortion at the time when the abort was due.

Abortion Applicants↗
PubMed1996

Barriers to contraceptive use in Kenya.

This study was designed to identify and to better understand the barriers to contraceptive use among Kenyan-couples. Data were collected through structured interviews and focus group discussions among couples not planning for pregnancy and not using any effective contraceptive method. The study was conducted in the Baba Dogo urban slum area of Nairobi, and Chwele, a rural sub-location in Bungoma, western Kenya. Some important barriers to contraceptive use were identified in couples wishing to space or limit further births. Those barriers included lack of agreement on contraceptive use and on reproductive intentions; husband's attitude on his role as a decision maker; perceived undesirable side effects, distribution and infant mortality; negative traditional practices and desires such as naming relatives, and preference for sons as security in old age. There were also gaps in knowledge on contraceptive methods, fears, rumours and misconceptions about specific methods and unavailability or poor quality of services in the areas studied. This paper recommends that information and educational programmes should be instituted to increase contraceptive knowledge, to emphasise the value of quality of life over traditional reproductive practices and desires, and to improve availability and quality of services.

Adolescent↗
PubMed2006

Mutagenesis as an unbiased approach to identify novel contraceptive targets.

To accommodate diverse personal needs in family planning, diverse contraceptive approaches are desirable. This goal requires identification of new contraceptive targets. Phenotype-driven mutagenesis is an unbiased approach to identify novel genes and functions in reproductive processes. The ReproGenomics Program at The Jackson Laboratory is a United States National Institutes of Health resource for production, identification and distribution of mutant mouse models of infertility that can be used for identification of potential targets for contraception. The strategy of this program is whole genome, random ENU mutagenesis, coupled with a phenotype screen for breeding failure as the only phenotype. A three-generation breeding scheme selects recessive mutations affecting reproductive functions. G3 males and females that fail to reproduce by natural mating to wild-type animals undergo secondary phenotype screens to assess gonad and accessory organ histology, hormone production, gamete production and gamete function in fertilization. The genetic transmission of the infertility trait in each family is confirmed and each mutation is genetically mapped to a defined chromosome region, facilitating identification of candidate genes from sequence and expression databases. Genes essential for fertility in both males and females and acting both meiotically and post-meiotically have been identified by this strategy. Phenotypes include male infertility with normal sperm count, but failure in fertilization of oocytes. Phenotype descriptions of each mutation are posted on the program website, . These unique reproductive mutant mouse resources will lead to new discoveries in andrology (and gynecology) research, as well as reproductive medicine. Dissection of gene function in known and newly discovered reproductive pathways will expand our focus to reveal novel targets for contraception.

Alkylating Agents↗
PubMed1991

Phase III clinical trial with a new oral contraceptive containing 150 micrograms desogestrel and 20 micrograms ethinylestradiol.

Results are presented of a Phase III international multicentre trial to study the effect of a new low-dose oral contraceptive (OC) containing 20 micrograms ethinylestradiol and 150 micrograms desogestrel (Mercilon) regarding efficacy, cycle control, blood pressure, and acceptability. Altogether 1,684 women from 12 European countries were included in the study. Four pregnancies occurred, 3 of them patient failures, one tablet failure. The overall Pearl Index was 0.20. The frequency of irregular bleeding was comparable to that recorded with other commonly used low-dose OCs. No serious side effects occurred. The incidence of the most frequently reported subjective side effects--headache, nausea and breast tension--was already low after the first cycle of treatment and decreased to below pretreatment levels with continued use. There was a small increase in mean body weight, which was confined essentially to young women. The preparation did not affect the mean systolic or diastolic blood pressure. This new preparation has thus proved to be an effective, safe and well-accepted ultra low-dose oral contraceptive.

Adult↗
PubMed2004

[Male views of contraceptive methods in a rural community in Bahia State, Brazil].

Family planning programs have traditionally concentrated on women. This study aimed to determine men's knowledge of contraceptive methods in a rural community in Bahia State, Brazil. Mean age of interviewees was 40.0 (+/-17.6) years. Avoiding unwanted pregnancy was reported as a responsibility of the couple by 39.7% of the male interviewees (n = 71) and as the man's responsibility by 26.8% (n = 48). The most widely known methods were condoms (98.9%) and the pill (96.6%). Condoms (22.9%), female sterilization (21.2%), and the pill (12.8%) were the most widely used methods. The majority of the interviewees (56.4%) reported that they "always" use some method. The men chose the method in 45.6% of the couples. The results indicate that more options for contraceptive methods should be offered, thereby facilitating the best choice of methods by the couple. Still, since in this study men chose the method in nearly half of the cases, it is necessary to prioritize couples' participation in family planning programs.

Adolescent↗
PubMed1990

Past use of oral contraceptives and cardiovascular disease: a meta-analysis in the context of the Nurses' Health Study.

We examined the effects of past use of oral contraceptives on risks of cardiovascular diseases prospectively in the Nurses' Health Study cohort. The 119,061 participants were 30 to 55 years old and free of coronary disease or stroke in 1976. They provided information on biennial questionnaires and were followed for 8 years. There were 380 nonfatal myocardial infarctions and 105 deaths from coronary disease, 282 strokes, and 48 other cardiovascular deaths. We observed virtually no differences in the rates of various cardiovascular diseases between never and past users of oral contraceptives, regardless of duration of use or time since last use. For major coronary disease, the relative risk was 0.8 (95% confidence intervals, 0.6 to 1.0). A quantitative meta-analysis of 13 studies yielded an estimated relative risk of 1.01 (95% confidence intervals, 0.91 to 1.13) for coronary heart disease. Past use of oral contraceptives has little or no impact on risks of subsequent cardiovascular diseases.

Adult↗
PubMed1989

The effect of levonorgestrel administered in large doses at different stages of the cycle on ovarian function and endometrial morphology.

In a pharmacokinetic study, levonorgestrel (L-NOG) 0.75 mg was administered orally to 10 swedish women in the early follicular phase of the menstrual cycle. L-NOG levels were measured after L-NOG administration. A peak level of 16 nmol/l was reached after 2 hours, T 1/2 was estimated to be 14.5 hours (8.5-18.5) in the 24-48-hour interval after dosing. Seventy-two women (in Stockholm, Bombay and Shanghai) were assigned to 4 treatment groups and studied during a control cycle, a treatment cycle and a posttreatment cycle when 0.75 mg L-NOG was administered orally for 4 days in the follicular phase, periovulatory period or luteal phase. Peripheral blood was drawn 3 times weekly during the entire study for the assay of estradiol and progesterone. In 22 women in Stockholm, an endometrial biopsy was obtained on cycle day 20-22 in all 3 cycles studied. When L-NOG was administered on periovulatory days 9, 11, 13, and 15, 3 women showed follicular activity only, 7 exhibited follicular activity followed by insufficient luteal function and 7 women ovulated normally. When L-NOG was administered on periovulatory days 11, 12, 16 and 19, 7 women ovulated during treatment, 6 women exhibited follicular activity followed by insufficient luteal function and 5 exhibited follicular activity only. When L-NOG was administered in the follicular or luteal phase, no effect on ovarian function was seen. No significant prolongation of the cycle lengths was seen when L-NOG was taken during the follicular phase. Only minor effects in the endometrium were observed during treatment.

Adult↗
PubMed1994

Prostaglandins and progesterone receptor antagonists in human fertility regulation.

Anti-progesterone medicines have now been extensively studied for human fertility regulation. The combination of the anti-progesterone Mifepristone with prostaglandin analogues such as Gemeprost and Misoprostol have been used in several European centres for medical abortion. Used before nine weeks gestation, these medicines have similar efficacy to surgical abortion. In addition, administration of progesterone antagonists within five days of unprotected intercourse appear effective in pregnancy prevention. Anti-progesterone medicines are not currently available in Australia. The introduction of progesterone receptor antagonists and modern prostaglandins would save approximately $10,000,000 per year to the Australian Health Budget. Furthermore, the introduction of progesterone receptor antagonists for emergency contraception would have even greater financial and emotional savings for Australian women. In Australia, when known carcinogens can be purchased over the counter, it is surely time for Australians to consider effective emergency contraception bought over the counter.

Abortion, Induced↗
PubMed1997

A process evaluation of condom availability in the Seattle, Washington public schools.

In 1993, Seattle began making condoms available in all of its 15 high schools. As part of an evaluation of this program, 16 focus groups with students from 13 high schools were conducted to explore students' perceptions of the school environment, program effectiveness, and suggestions for program improvement. The study also included data from a student survey conducted in 10 high schools. The focus group results revealed that students support school condom availability but have concerns about privacy when obtaining condoms. Students prefer obtaining condoms from baskets in private areas of school-based clinics to obtaining them from vending machines. Students do not believe that having condoms available has affected sexual activity or condom use among students. Recommendations for improving school condom availability include access to free condoms in private locations.

Adolescent↗
PubMedDate not supplied

Emergency contraceptive pills: a 10-year follow-up survey of use and experiences at college health centers in the mid-Atlantic United States.

The authors conducted a 10-year follow-up study using a telephone survey to investigate the availability of emergency contraceptive pills (ECPs) at college health centers in the mid-Atlantic region of the United States. They also examined related issues, such as distribution procedure, existence of a written protocol, personnel involved, contraindications, follow-up procedures, methods of advertising, staff attitudes, changes in distribution over the past 10 years, and availability if ECPs become over-the-counter. Of the 119 completed responses, 58 schools (49%) reported distributing ECPs. The most common reasons schools listed for not distributing ECPs (n = 61, 51%) were religious convictions, understaffing, and lack of funding. Major changes in ECP distribution over the past 10 years related primarily to the number of schools distributing ECPs, protocol in ECP distribution, and advertising for ECP services.

Adolescent↗