Contraceptive efficacy of emergency contraception with levonorgestrel given before or after ovulation |
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Authors: | Noé Gabriela Croxatto Horacio B Salvatierra Ana María Reyes Verónica Villarroel Claudio Muñoz Carla Morales Gabriela Retamales Anita |
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Affiliation: | aInstituto Chileno de Medicina Reproductiva, Santiago, Chile;bLaboratorio de Inmunología de la Reproducción, y Centro para el Desarrollo de Nanociencia y Nanotecnología, Universidad de Santiago de Chile, Santiago, Chile |
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Abstract: | BackgroundThe contraceptive efficacy of emergency contraceptive pills containing levonorgestrel (LNG-EC) has been estimated in most previous studies by judging the day of ovulation from presumptive menstrual cycle data, thus providing poorly reliable estimates.MethodsIn the present study, the efficacy of LNG-EC was determined in 393 cycles by dating ovulation on the basis of reliable hormonal and ovarian parameters validated by a database constructed in a separate study. In addition, the efficacy was determined separately for cycles in which LNG-EC was given before or after ovulation.ResultsFor the 148 women who had sexual intercourse during the fertile days, the overall accumulated probability of pregnancy was 24.7, while altogether 8 pregnancies were observed. Thus, the overall contraceptive efficacy of LNG-EC was 68%. Among the 103 women who took LNG-EC before ovulation (days −5 to −1), 16 pregnancies were expected and no pregnancy occurred (p<.0001). Among the 45 women who took LNG-EC on the day of ovulation (day 0) or thereafter, 8 pregnancies occurred and 8.7 were expected (p=1.00). These findings are incompatible with the inhibition of implantation by LNG-EC in women. The same cases were also analyzed using the presumptive menstrual cycle data, and important discrepancies were detected between the two methods.ConclusionThe efficacy of LNG-EC has been overestimated in studies using presumptive menstrual cycle data. Our results confirm previous similar studies and demonstrate that LNG-EC does not prevent embryo implantation and therefore cannot be labeled as abortifacient. |
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Keywords: | Emergency contraception Levonorgestrel Contraceptive efficacy |
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