Study on the effects of a single implant containing nomegestrol acetate (UNIPLANT)
on the hormonal profile, endometrial morphology and ultrasonographic evaluation
of ovarian function
I.C. Barbosa, H. Maia Jr, R. Lopes, A.C.V. Lopes, E.M. Coutinho
Department of Gynecology, Obstetrics and Human Reproduction, Federal
University of Bahia, Salvador, Bahia, Brazil
Objectives: The objective of this study was to evaluate the effects of
a single silastic implant containing 55 mg+10% of nomegestrol acetate on
the hormonal profile, endometrial morphology, cervical mucus, maturation index
and evaluation of ovarian function by vaginal sonography, during one year.
Material & Methods: Twenty healthy women of reproductive age (18–30
years old) participated in this study. Prior to implant insertion, a clinical
examination was carried out, which included: a general medical and gynecological
examination, as well as the collection of cervical/vaginal material for cytology
and maturation index. Hysteroscopy with endometrial biopsy was carried out
during the control cycle in all patients. All patients were submitted to a
second hysteroscopy during the study, five during the second month of use, five
during the sixth month and ten during the twelfth month of UNIPLANT use. In the
same cycle in which hysteroscopy was performed, hormone measurement, vaginal
sonography and cervical mucus collection was carried out thrice weekly.
Results: Based on levels of plasma progesterone, 80% of cycles studied
in users of UNIPLANT were anovulatory. In 56% of cycles, the presence of
persistent, non-luteinized follicles was observed. Cervical mucus was evaluated
according to criteria established by the World Health Organization and showed a
marked reduction during treatment cycles in all parameters studied. Endometrial
thickness was <8 mm in all treated cycles in the study. Alterations in the endometrial architecture were observed in the majority of treated cycles and consisted of the presence of a thin endometrium with a marked increase in vascularization.
Conclusion: This study demonstrates that UNIPLANT is a long-acting
contraceptive method that probably functions at hypothalamic-hypophyseal level,
on the ovary, the endometrium and in cervical mucus production.
