Human Reproduction, Vol 12, 2671-2675, Copyright © 1997 by Oxford University Press
E Mandelin, H Koistinen, R Koistinen, B Affandi and M Seppala
Intrauterine devices (IUDs) exert contraceptive action by interfering with
sperm transport, ovum development, fertilization and implantation.
Glycodelin A (GdA) is a uterine glycoprotein that has local contraceptive
activity by inhibiting sperm-egg binding. GdA is normally absent from
endometrium during the fertile midcycle and it is not expressed until the
fifth postovulatory day. The phase of menstrual cycle addressed in this
study covers the phase when conception is most likely to follow an
unprotected intercourse and when GdA is normally absent. We present here
evidence that levonorgestrel-releasing IUD (LNg- IUD) is accompanied by
'inappropriate' expression of GdA in endometrium between days 7 and 16 of
the menstrual cycle (six out of six cases). The same was also found in
copper-releasing IUD (Cu-IUD)-wearing women, but less frequently (four out
of 11 cases, P < 0.0345, Fisher's exact test). In-situ hybridization
localized GdA mRNA into endometrial glands in the midcycle endometrium,
confirming the cellular site of synthesis. Based on the potent inhibitory
activity of GdA on sperm-egg binding, the presence of GdA in uterine glands
of IUD wearers may lead to prior exposure of sperm to contraceptive GdA,
thus contributing to the contraceptive activity of the IUD.
ARTICLES
Levonorgestrel-releasing intrauterine device-wearing women express contraceptive glycodelin A in endometrium during midcycle: another contraceptive mechanism?
Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Haartmaninkatu, Finland.
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