Human Reproduction, Vol. 17, No. 10, 2594-2599,
October 2002
© 2002 European Society of Human Reproduction and Embryology
Ovarian function with a novel combined contraceptive vaginal ring
1 Clinical Development Department, NV Organon, Oss, The Netherlands and 2 Centre for Reproductive Medicine, Academic Hospital V.U.B., Laarbeeklaan 101, B-1090 Brussels, Belgium
BACKGROUND: NuvaRing® is a combined contraceptive vaginal ring designed for 3 weeks continuous use followed by a 1 week ring-free period. The present study evaluated ovarian function in women who were instructed to either adhere to, or deviate from, the recommended regimen of use. METHODS: In this open-label, randomized study, 45 women aged between 18 and 35 years used NuvaRing for one cycle in which the ring was used according to the recommended regimen. Women in group A (n = 15) then continued with a ‘normal’ 3 week period of ring use after which the restoration of ovarian function—i.e. the time to ovulation—for each woman was determined by daily vaginal ultrasound and serum hormone levels. For women in group B (n = 15), the second cycle consisted of only 3 consecutive days of ring use, after which each woman was monitored until ovulation. Women in group C (n = 15) were not permitted to start a second ‘normal’ cycle until a follicle with a diameter of 13 mm was observed by vaginal ultrasound; subsequently, the development of these follicles during the second cycle of ring use was monitored daily. RESULTS: Irrespective of the length of the second cycle, 3 weeks (group A) versus 3 days (group B), a new cohort of follicles needed to be recruited and the time to ovulation after ring removal was similar (19 versus 17 days). The median time needed to develop a follicle up to 13 mm in diameter (group C) was 11 days (range 8–21 days); none of the women ovulated after insertion of the second ring. CONCLUSION: NuvaRing is a highly effective, reversible method of hormonal contraception. Ovulation, at least until the stage of a 13 mm dominant follicle, is prevented and as little as 3 consecutive days of NuvaRing use interferes with follicle growth.
Key words: compliance/etonogestrel/ovarian function/vaginal ring
3 To whom correspondence should be addressed at: Clinical Development Department, NV Organon, P.O.Box 20, 5340 BH Oss, The Netherlands. E-mail: thom.dieben{at}organon.com
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  I. J.M. Duijkers, C. Klipping, C. H.J. Verhoeven, and T. O.M. Dieben Ovarian function with the contraceptive vaginal ring or an oral contraceptive: a randomized study Hum. Reprod., November 1, 2004; 19(11): 2668 - 2673. [Abstract] [Full Text] [PDF]
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