Microdose intrauterine progestagen associated with intrauterine contraceptive devices
Horne, H.W.; Scott, J.M.; Underwood, R.H.
International Journal of Fertility 15(4): 210-213
1970
ISSN/ISBN: 0020-725X PMID: 5487545 Document Number: 25759
This study investigated the response of the human female to a potent progestagen implanted in a Silastic capsule attached to an IUCD and inserted into the uterine cavity. Megestrol acetate's permeability was laboratory tested using tritiated material since the daily amount of progestagen eluted was too small to be determined by other methods. Polyethylene capsules with Silastic plugs allowed a daily elution into the surrounding bath of about 1% of the daily dose needed for satisfactory systemic contraceptive effect. Such capsules, loaded with 2.7 mcg of megestrol acetate, were attached to Maizlin Springs and used through 3 cycles of 3 months each for 5 patients. After removal the capsules were tested for residual progestagen by paper chromatography. All capsules still had residual medication after 3 month's use. Control tests were also done for preinsertion and postremoval cycles. Other contraceptive measures were used only during these control cycles. Continuous basal temperature records were obtained. During the 28 recorded cycles, 43 plasma progesterone tests, 42 urinary pregnanediol excretions, and 38 endometrila biopsies were obtained. No evidence of cyclic derangement was evidenced. All temperature records were biphasic. Ovulation was consistently confirmed. 1 patient developed acute endometritis during the second treatment cycle. This required premature removal of the IUCD. Studies are in progress to determine the highest intrauterine dosage which will cause no systemic effect but should make nidation impossible and thus protect completely against intrauterine pregnancy without the risks of other routes of aadministration.