Hum. Reprod. Advance Access originally published online on May 30, 2007
Human Reproduction 2007 22(8):2190-2195; doi:10.1093/humrep/dem119
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In vivo assessment of the human sperm acrosome reaction and the expression of glycodelin-A in human endometrium after levonorgestrel-emergency contraceptive pill administration
1 Human Reproduction Unit, Department of Obstetrics and Gynaecology, School of Medicine, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil 2 Department of Clinical Chemistry, Helsinki University Central Hospital, Biomedicum Helsinki, Finland 3 Laboratory of Reproductive Studies, Department of Clinical Biochemistry, School of Biochemical and Pharmaceutical Sciences, Universidad Nacional de Rosario, Rosario, Argentina 4 Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Biomedicum Helsinki, Finland 5 Department of Pathology, School of Medicine, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil
6 Correspondence address. Caixa Postal 6181, 13084-971 Campinas, São Paulo, Brazil. Tel: +55-19-3289-2856; Fax: +55-19-3289-2440; E-mail: bahamond{at}caism.unicamp.br
BACKGROUND: The objectives were firstly to assess acrosome reaction (AR) status of spermatozoa following uterine flushing, secondly to measure levonorgestrel (LNG) levels in serum and in uterine flushing fluid and finally to measure endometrial glycodelin-A expression after administration of LNG as a form of emergency contraception (EC).
METHODS: Forty-eight experiments were conducted on 15 regularly menstruating women. Four groups were formed based on different intercourse to treatment interval and treatment to recovery of spermatozoa and the biopsies.
RESULTS: Twenty-four and forty-eight hours after treatment, there were 14.5 ± 3.9 x 106 and 17.3 ± 6.8 x 106 sperm recovered from the uterus, respectively. There were no differences between the AR rate and the endometrial glycodelin-A staining intensity in an LNG or placebo treated cycles. The LNG in uterine flushing medium represented 1.38% of the values observed in serum 24 h after the LNG intake.
CONCLUSIONS: Twenty-four and forty-eight hours after administration of EC, neither the proportion of AR sperm, nor the glycodelin-A level was influenced by 1.5 mg of LNG. LNG did not impair the cervical mucus either because viable spermatozoa were found in the genital tract 36–60 h after coitus and 24–48 h after LNG intake. The mechanism of action of LNG as EC remains unknown.
Key words: emergency contraception/levonorgestrel/human spermatozoa/acrosome reaction/glycodelin-A
Submitted on December 26, 2006; resubmitted on February 28, 2007; accepted on April 11, 2007.