PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 11108876

Progestin implants.

H B Croxatto
View original source ↗Export metadata ↓

Abstract

Progestin implants for contraception are highly effective, safe, and the most convenient choice for many women. Progestin implants currently on the market, preparing for launch, or under investigation are reviewed here. Their basic galenic and pharmacokinetic features, as well as their contraceptive effectiveness, are described. The first progestin-only contraceptive implant placed on the market was Norplant, a multiunit system. Since then, several single- and double-rod implants have been developed, each using one of four different progestins: levonorgestrel, etonogestrel, Nestorone and nomegestrol acetate. Jadelle is similar to Norplant but consists of only two, rather than six, Silastic rods to simplify insertion and removal; nevertheless, levonorgesterel serum levels are identical, and performance is the same for both systems. The single implant systems reviewed here are: Implanon with a 3-year duration; Nestorone implants for breast feeding and non-breast feeding women lasting up to 2 years; and Uniplant, which is effective for 1 year. The advantages and disadvantages of progestin implants, the importance of counseling for increasing user satisfaction, and the future outlook for this contraceptive method are also discussed.

Explore related subjects

Administration, IntravaginalContraceptive Agents, FemaleDelayed-Action PreparationsDrug ImplantsFemaleHumansPregnancyProgestinsJournal ArticleReview

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

H B Croxatto. Progestin implants.. https://doi.org/10.1016/s0039-128x(00)00124-0

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2002

[Indication for labor induction by prostaglandin E2 vaginal gel. Retrospective study of a continuous series of 170 patients].

OBJECTIVE: To assess the factors of efficacy, side effects and complications following vaginal application of prostaglandin E2 (PGE2). METHODS: Retrospective study of 170 women in whom a PGE2 vaginal gel was administered between June 1, 1999 and June 1, 2000. The efficacy (labor effectively induced), quality of myometrial response, side effects and complications were studied globally and in each clinical context: intra-uterine delayed growth (IUDG), pre-eclampsia without IUDG, diabetes, pregnancy prolonged without IUDG, anomaly in fetal heart rate (FHR) and/or in amniotic liquid without IUDG discovered during the systematic monitoring at the end of pregnancy, premature rupture of the membrane without IUDG. RESULTS: The overall success (defined as the onset of labor) was of 94.1%. This rate was of 90.7% in primiparous and of 100% in multiparous women. Twenty-three patients (13.5%) experienced side effects (hyperkinesia or hyperthermia) and 35 patients (20.6%) complications (hyperkinesia or hypertonia with fetal repercussion). The maternal-response to infection was significantly improved (p < 0.05) in cases of prolonged rupture of the membranes or anomaly discovered during monitoring, but only in patients with diabetes. In cases of IUDG of vascular etiology with multiparity, the total quantity of PGE2 necessary was only of 1.14 mg and 85% of patients subsequently delivered without ocytocine. CONCLUSION: IUDG and prolonged pregnancy are the principle indications for PGE2 vaginal gels. The quality of response depends on the clinical context. In cases of premature rupture of the membranes or of anomaly discovered during monitoring (FHR and amniotic liquid), response was only improved in diabetic patients. In cases of vascular IUDG and multiparity, the response was excellent and the majority of women subsequently delivered without ocytocine, thus confirming the quality of myometrial response. Hence, the quantity of PGE2 required varied, depending on the subjecent pathology. This strategy could limit the risk of excessive myometrial response (hyperkinesia or hypertonia) and thus improve fetal tolerance.

Administration, Intravaginal↗
PubMed2002

Effect of deposition site and sperm number on the fertility of sheep inseminated with liquid semen.

The effect of the deposition site and the numbers of sperm on the fertility of sheep was tested in a field trial in which 1292 Norwegian crossbred ewes aged between six months and five-and-a-half years from 52 farms were inseminated with liquid semen after natural oestrus. Cervical insemination with 150 x 10(6) and 75 x 10(6) spermatozoa resulted in 25-day non-return rates of 63.7 and 56.1 per cent, and vaginal insemination gave non-return rates of 63.3 and 56.6 per cent, respectively. There was no significant difference between the cervical and vaginal inseminations, but the inseminations with 150 x 10(6) spermatozoa gave significantly higher non-return rates (P=0.004). There were significant differences between the non-return rates for different rams (P<0.0001) and farmers (P=0.0002) but the age of the ewe had no significant effect.

Administration, Intravaginal↗