EARLY LUTEAL-PHASE TREATMENT WITH MIFEPRISTONE (RU-486) FOR FERTILITY REGULATION
EARLY LUTEAL-PHASE TREATMENT WITH MIFEPRISTONE (RU-486) FOR FERTILITY REGULATION
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DOI：
10.1093/oxfordjournals.humrep.a138157
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发表时间：
1993-06-01
影响因子：
6.1
通讯作者：
BYGDEMAN, M
中科院分区：
文献类型：
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作者：
GEMZELLDANIELSSON, K;SWAHN, ML;BYGDEMAN, M
米非司酮（RU 486）是一种抗孕酮的药物，在受体水平上与孕酮相互作用。排卵后立即服用米非司酮不会扰乱月经周期。然而，子宫内膜的成熟和功能受到抑制，子宫收缩力改变。为了测试这些效果是否足以防止植入，21名妇女同意使用一个单一的治疗与200毫克米非司酮的促黄体生成素（LH）日+2个月作为他们唯一的避孕方法。这些妇女接受了1 - 12个月的治疗。LH峰值的时间由女性自己使用快速LH测试（Ovu-quick，Organon）在尿液中确定。研究的总周期数为169。在12个周期中，妇女无法检测到LH峰。在这些周期中，没有给予治疗，建议妇女在月经期间使用屏障方法。其余157个LH峰值可检测的周期，根据血浆孕酮测定均为排卵周期。发生了一次怀孕。根据LH峰值出现的时间，回顾性计算了124个周期中至少有一次性交发生在排卵前3天至排卵后1天。因此，在月经周期的这段时间怀孕的概率是0.008。在35%的周期中，除了治疗后几天开始的2 - 3天轻微出血外，女性没有抱怨任何治疗相关的副作用。结果表明，米非司酮对子宫内膜的作用足以预防妊娠，并表明抗孕激素治疗也可用于避孕目的。
Mifepristone (RU 486) is an antiprogestin which interacts with progesterone at the receptor level. Administration of mifepristone immediately after ovulation does not upset the menstrual cycle. However, the maturation and function of the endometrium is inhibited and uterine contractility is changed. To test if these effects are sufficient to prevent implantation, 21 women agreed to use one single treatment with 200 mg mifepristone on day luteinizing hormone (LH) + 2 monthly as their only contraceptive method. The women were treated for 1 - 12 months. The time of the LH peak was determined in the urine by the women themselves using a rapid LH test (Ovu-quick, Organon). The overall number of cycles studied was 169. In 12 cycles the women were unable to detect the LH peak. In these cycles no treatment was given and the women advised to use barrier methods during the time to menstruation. The remaining 157 cycles with a detectable LH peak were all ovulatory based on plasma progesterone measurement. One pregnancy occurred. On the basis of the time of the LH peak, it was retrospectively calculated that in 124 cycles at least one act of intercourse occurred during the period 3 days before to 1 day after ovulation. The probability of pregnancy in this period of the menstrual cycle is thus 0.008. The women did not complain of any treatment-related side-effects apart from slight bleeding for 2 - 3 days starting a few days after the day of treatment in 35% of the cycles. The results show that the effect of mifepristone on the endometrium is sufficent to prevent pregnancy and indicate that treatment with antiprogestin can also be used for contraceptive purposes.