Human Reproduction, Vol 13, 3379-3383, Copyright © 1998 by Oxford University Press
I Jarvela, A Tekay and P Jouppila
To determine the effect of long-acting intrauterine progestin on the
impedance to blood flow in the uterine arteries, we applied a
levonorgestrel-releasing (20 microg/day) intrauterine contraceptive system
(LNG-IUS) to the uterine cavity of 27 fertile, regularly menstruating
women. Measurements were performed using transvaginal colour Doppler
ultrasonography in the mid-luteal phase and on day 1 of menstruation in the
absence of the LNG-IUS and 3 months later in its presence. The mean (SD)
mid-luteal uterine artery pulsatility index (PI) had risen from a
pretreatment level of 2.28 (0.48) to 2.70 (0.67) after 3 months use of the
LNG-IUS (P < 0.01), but as regards day 1 of menstruation, no change was
observed. The increase in the mean PI (SD) at the mid-luteal phase was
present only in subjects with serum levonorgestrel concentrations >200
pg/ml (n = 16) [pretreatment, 2.25 (0.47); with LNG-IUS, 2.83 (0.59), P
< 0.001], and absent in those with serum levonorgestrel concentrations
<200 pg/ml (n = 10) [pretreatment, 2.31 (0.53); with LNG-IUS, 2.51
(0.79), ns]. Mean progesterone concentrations were lower with the LNG-IUS
in place in both groups. We conclude that a levonorgestrel-releasing
intrauterine device appears to increase the impedance to blood flow in the
uterine arteries during the mid-luteal phase in correlation with serum
concentrations of LNG and a concomitant decrease in serum progesterone
concentrations.
ARTICLES
The effect of a levonorgestrel-releasing intrauterine system on uterine artery blood flow, hormone concentrations and ovarian cyst formation in fertile women
Department of Obstetrics and Gynaecology, Oulu University Hospital, Finland.
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