PubMed · 12738538
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Jerome H Check, Vincent Graziano. 2003. Multiple confounders--measured with error?. https://doi.org/10.1016/s0015-0282(03)00381-9
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OBJECTIVE: To compare side effects and patient inconvenience of two vaginal progesterone (P) formulations for luteal support in in vitro fertilisation cycles. STUDY DESIGN: Sixty infertile patients at risk of developing ovarian hyperstimulation syndrome were randomised to receive either Cyclogest vaginal suppositories 400mg twice daily or Crinone 8% vaginal gel once daily for 14 days as the luteal support. On Day 6 and Day 16 after embryo transfer, they rated side effects and patient inconvenience into four grades: none, mild, moderate and severe by completing a questionnaire. RESULTS: Perineal irritation was reported by about 20% of patients in each group. Significantly more patients using Cyclogest suppositories graded inconvenience of administration, leaking out and interference with coitus as moderate or severe. CONCLUSION: There was no difference in perineal irritation after Cyclogest suppositories or Crinone 8% gel although significantly more patients found inconvenience of administration, leaking out and interference with coitus after Cyclogest.
The vaginal contraceptive ring works systemically by releasing 120 micrograms etonogestrel (a third generation progestogen) and 15 micrograms ethinylestradiol per day. As little independent research has been done on the efficacy and effectiveness of the vaginal contraceptive ring, it seems too early for the uncompromising propagation of systemic vaginal contraception. Women who occasionally omit to take the pill and those reluctant to use an intra-uterine device may possibly benefit from this form of contraception.
OBJECTIVE: To assess the tolerability and endometrial effects of vaginal administration of an allopregnanolone gel to postmenopausal women undergoing estrogen therapy. METHODS: Thirteen postmenopausal women included in the study were divided into two groups and submitted to two consecutive cycles of 28 days during which they received 2 mg oral estradiol valerate daily and vaginally administered allopregnanolone gel during the last 10 days of the second cycle (group 1) or during the last 10 days of each cycle (group 2). Systemic adverse effects, vaginal bleeding and endometrial histology were characterized, with group 1 patients being submitted to two endometrial biopsies (days 28 and 56) and group 2 patients to one biopsy (day 56). RESULTS: Five patients did not show any adverse effect. Mastalgia was the most frequently reported adverse effect (four cases), followed by headache and abdominal pain (two cases each). The adverse effects were mild and did not interfere with the adequate use of the medication prescribed. Vaginal bleeding due to deprivation was observed in three of the seven patients submitted to one treatment cycle with allopregnanolone (group 1) and in two of six patients submitted to two treatment cycles (group 2). Endometrial biopsy findings did not suggest any secretory action after exposure to allopregnanolone. CONCLUSIONS: Tolerability of vaginal administration of allopregnanolone gel was good. Studies employing a larger series and longer time of follow-up are necessary to determine the endometrial effects of this drug.