Many contraceptive drugs have abortifacient (anti-implantation) effects that they are not telling. What has a bad effect on one aspect of the body (prevention of ovulation) will be expected to have other negative effects as well, but this survey is just surprising.
Successful implantation requires
a receptive endometrium,
a normal embryo at the blastocyst developmental stage and
a synchronized dialogue between maternal and embryonic tissues
The device which is used in the intrauterine drug delivery system is known as an Intrauterine device (IUD) (2). IUDs or intrauterine devices are small artificial objects or devices inserted into the uterus to prevent the occurrence of pregnancy by disrupting the fertilization process as a result of sexual intercourse. They have gained popularity in recent times and are one of the most effective methods of birth control in terms of long-term contraception. It can be easily installed and is flexible. These devices are usually small in size and inserted through the cervix. IUDs reduce the need for abortion with unwanted pregnancies by preventing the effective movement of eggs and sperm. However, it cannot confirm the spread of STIs or STDs such as HIV, gonorrhoea, etc
Topics covered
Introduction
Advantages
Disadvantages
Development of intra uterine devices (IUDs)
Applications
References
Successful implantation requires
a receptive endometrium,
a normal embryo at the blastocyst developmental stage and
a synchronized dialogue between maternal and embryonic tissues
The device which is used in the intrauterine drug delivery system is known as an Intrauterine device (IUD) (2). IUDs or intrauterine devices are small artificial objects or devices inserted into the uterus to prevent the occurrence of pregnancy by disrupting the fertilization process as a result of sexual intercourse. They have gained popularity in recent times and are one of the most effective methods of birth control in terms of long-term contraception. It can be easily installed and is flexible. These devices are usually small in size and inserted through the cervix. IUDs reduce the need for abortion with unwanted pregnancies by preventing the effective movement of eggs and sperm. However, it cannot confirm the spread of STIs or STDs such as HIV, gonorrhoea, etc
Topics covered
Introduction
Advantages
Disadvantages
Development of intra uterine devices (IUDs)
Applications
References
We are Leading IVF Clinic India offer IVF treatments with state of art facility and High Success rate. We are pioneering the field of Fertility Managment
Successful implantation of the embryos in the uterus after IVF cycle is about 20%. It represents the bottleneck in the procedure of in vitro fertilization and embryo transfer. In this presentation we look at factors affecting implantation and how to improve it.
To overcome from unplanned pregnancy issues Buy Mifepristone pills are available online at pharmacy stores. Mifepristone is the FDA approved pill used by the women to terminate the pregnancy without any side effect.
For more visit : http://www.mtpabortionpill.com/mifepristone.html
In settings with limited access to health care, misoprostol is an important intervention that could reduce maternal deaths both directly and through the more cost-effective use of health services. Misoprostol is, however, a powerful drug that needs to be used with care. Evidence-based information about the safest regimens should be widely disseminated so as to prevent its inappropriate use
We are Leading IVF Clinic India offer IVF treatments with state of art facility and High Success rate. We are pioneering the field of Fertility Managment
Successful implantation of the embryos in the uterus after IVF cycle is about 20%. It represents the bottleneck in the procedure of in vitro fertilization and embryo transfer. In this presentation we look at factors affecting implantation and how to improve it.
To overcome from unplanned pregnancy issues Buy Mifepristone pills are available online at pharmacy stores. Mifepristone is the FDA approved pill used by the women to terminate the pregnancy without any side effect.
For more visit : http://www.mtpabortionpill.com/mifepristone.html
In settings with limited access to health care, misoprostol is an important intervention that could reduce maternal deaths both directly and through the more cost-effective use of health services. Misoprostol is, however, a powerful drug that needs to be used with care. Evidence-based information about the safest regimens should be widely disseminated so as to prevent its inappropriate use
Invited Lecture delivered by Dr Sujoy Dasgupta in the Annual Conference of ISAR (Indian Society of Assisted Reproduction) held at Kolkata in November, 2019
Uterine Fibroids: Symptoms, Causes, Risk Factors & Treatment uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer
Contraception
Contraception is defined as the intentional prevention of conception through the use of various devices, sexual practices, chemicals, drugs or surgical procedures.
The preventive methods to help women avoid unwanted pregnancies are called contraceptive methods.
Need for contraception
• To avoid unwanted pregnancies.
• To regulate the timing of pregnancy.
• To regulate the interval between pregnancy.
Ideal Contraceptive
• Safe
• Effective
• Acceptable
• Reversible
• Inexpensive
• Long lasting
• Requires little or no medical supervision
Contraceptive methods
Spacing methods
Natural
Barrier
IUDs
Emergency contraception
Terminal methods
Male fertilisation
Female fertilisation
Natural Methods
Coitus inteyrruptus / withdrawal
Rhythm Method
Lactational Amenorrhoea
Barrier Methods
Mechanical
Male : Condom
Female : Condom, Diaphragm, Cervical cap
Chemical
Creams - Deleen
Jelly – Koromex, Volpar paste
Foam tablets – Aerosol foams, Chlorimin T or Contab
Combination
Combined use of Chemical and Mechanical methods.
Male condom
• Most commonly known and used contraceptive.
• Better known in India as NIRODH.
Female condom
Femidom
Diaphragm
Spermicides
Spermicides are surface active agents which attach
themselves to spermatozoa and kill them.
Available in various forms like
Intrauterine Contraceptive Devices
Cu T200
T shaped device Polyethylene frame.
215 mm2 surface area of Cu wire.
Contains 124 mg of copper
Cu is lost at the rate of 50 µg/day.
Polyethylene monofilament tied at vertical stem.
Cu is radio opaque so additionally barium is
incorporated in the device.
Supplied in a sterilised sealed packet.
Lifetime 4 years.
Cu T 380A
380 mm square surface area of copper wire.
Replacement 10 years.
Multiload Cu 250
60-100 ug/day
Replacement 3 years
Multiload - 375
Mode of action
Biochemical and histological changes in endometrium.
Increased tubal motility.
Endometrial inflammatory response.
Prevents implantation.
Contraindication for insertion of IUCD
Presence of pelvic infection
Genital tract bleeding (undiagnosed)
Suspected pregnancy
Uterine fibroid
Severe dysmenorrhoea
Ectopic pregnancy history
Caesarean section
Cu allergy
Time of insertion
Interval
2-3 days after menstrual phase.
During lactational amenorrhoea.
Postabortal
Done immediately following termination of pregnancy.
Postpartum
After 6 weeks of delivery.
Postplacental delivery
Post delivery of placenta.
Method of Insertion
Preliminary steps:
History taking and examination
Patient is informed and consent is obtained.
Insertion is done in OPD aseptic conditions.
Placement of device in inserter.
Steps of operation
The patient is asked to remain empty bladder.
The patient is placed in lithotomy position.
Local antiseptic cleaning is done.
Posterior vaginal speculum is introduced.
Anterior lip of cervix is grasped with Allis tissue forcep.
The device is placed in the inserter and introduced through cervical
The thin endometrium refers to the lining of the uterus, known as the endometrium, being insufficiently thick. This condition is typically characterized by a reduced thickness of the endometrial layer, which plays a crucial role in supporting the implantation and development of a fertilized egg during the menstrual cycle.
A thin endometrium is commonly associated with hormonal imbalances, such as low estrogen levels, which are vital for the growth and maintenance of the endometrial tissue. Inadequate blood flow to the uterus, chronic inflammation, or certain medical conditions can also contribute to this condition. Women with a thin endometrium may experience difficulties in achieving and maintaining pregnancy, as the thin lining may not provide an optimal environment for the embryo to implant and thrive.
Addressing the underlying causes of a thin endometrium often involves hormonal therapies to regulate estrogen levels, lifestyle modifications, and sometimes surgical interventions. Fertility treatments, such as in vitro fertilization (IVF), may be considered to overcome the challenges associated with a thin endometrium.
In conclusion, a thin endometrium can pose challenges to fertility and reproductive health, requiring a comprehensive approach to address the underlying factors and improve the chances of successful conception.
Role of progestogens in obstetrics and gynecologyAhmad Saber
The
different progestogens with their overlapping effects on estrogen, androgen, glucocorticoid,
and mineralocorticoid receptors are described in order to allow the clinician to make the most appropriate choice of progestogen.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Cyproterone acetate+ Ethinylestradiol
(Chloe, Althea,Cybelle)
• MECHANISM OF ACTION
Quote: Cyproterone acetate is a progestogen derivative, and the other
ingredient, ethinylestradiol, is a synthetic version of the naturally-
occurring female hormone, oestrogen. The medicine works as a
contraceptive by preventing the ripening and release of eggs from the
ovaries, as well as increasing the thickness of the cervical mucus,
which makes it more difficult for sperm to cross from the vagina into
the womb. It also changes the lining of the womb so that it is less
suitable for any fertilised eggs to successfully implant in.
• REFERENCE http://www.netdoctor.co.uk/medicines/skin-and-
hair/a6558/dianette-cyproterone-acetate-and-ethinylestradiol/
• CONCLUSION Abortifacent
3. Desogestrel + Ethinylestradiol
(Estrelle Plus, Mercilon, Marvelon 28,
Gracial)
• MECHANISM OF ACTION/QUOTE: Combined oral
contraceptives act by suppression of gonadotropins.
Although the primary mechanism of this action is
inhibition of ovulation, other alterations include
changes in the cervical mucus, which increase the
difficulty of sperm entry into the uterus, and changes
in the endometrium which reduce the likelihood of
implantation
• REFERENCE https://www.drugs.com/pro/desogestrel-
and-ethinyl-estradiol.html
• CONCLUSION Abortifacent
4. Drospirenone+ Ethinylestradiol
(Lizonya, Yasmin, Lizelle, Yaz)
• MECHANISM OF ACTION/QUOTE: Since the pill-free interval is only 7 days, in most women the
follicle does not mature to the point of ovulation, and therefore most OCP cycles are anovulatory.
Since the OCP also has a progestin for at least 21 day, the cervical mucus is also altered. With
estrogen alone, the cervical mucus is thin, clear, and copious with Spinnbarkeit noted. Once a
progestin is introduced, the cervical mucus becomes thick, sticky, pasty and scant. It is this
progestin-affected cervical mucus in the combination OCP that produces an environment that
makes it difficult for sperm to enter the uterus. The progestin also alters motility of the uterus and
oviduct as the normal transport of both the ovulated ova traveling down the fallopian tube and the
sperm that are traveling up the fallopian tube to fertilize this ova is interrupted. Progestins also
alter the endometrium, such that the glandular production of glycogen is diminished.
• REFERENCE Bachmann G, Kopacz S. Drospirenone/ethinyl estradiol 3 mg/20 μg (24/4 day regimen):
hormonal contraceptive choices – use of a fourth-generation progestin. Patient preference and
adherence. 2009;3:259- 264. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778416/#b1-ppa-3-
259
• REFERENCE ON “GLYCOGEN (PLAYING) AN IMPORTANT ROLE IN NUTRITIONAL WELFARE OF
PREIMPLANTATION BLASTOCYSTS” p/ 136, para 2 Implantation of the Ovum. Koji Yoshinaga, Roland
K. Meyer, Roy Orval Greep Harvard University Press, 1976, 161 pages
https://books.google.com/books?id=vVzUZpdR_3wC&pg=PA136&lpg=PA136&dq=progestins+and+
glycogen+and+implantation&source=bl&ots=77J_3OpR7e&sig=dMlwnwxPrrsUvlyQTRMc9R1Mtnc&
hl=en&sa=X&ved=0ahUKEwj2jdqC0f3VAhVI54MKHSDpB9QQ6AEIPjAE#v=onepage&q=progestins%
20and%20glycogen%20and%20implantation&f=false
• CONCLUSION Because this decreases glycogen, the mechanism of action is probably/likely
also ABORTIFACENT.
5. Estradiol Valerate + Dienogest (Olaira)
• MECHANISM OF ACTION/ QUOTE: The progestin
component prevents the luteinizing hormone surge
required for release of the ovum. It also serves to thicken
cervical mucus and decrease tubal motility, creating a less
facile passage for sperm. In addition, the progestin acts to
thin the endometrium, resulting in tissue less receptive to
implantation.
• REFERENCE Kiley, Jessica W, and Lee P Shulman. “Estradiol
Valerate and Dienogest: A New Approach to Oral
Contraception.” International Journal of Women’s Health 3
(2011): 281–286. PMC. Web. 12 Sept. 2017.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163658/
• CONCLUSION Abortifacent
6. Etonogestrel
(Implanon, Implanon NXT)
• The contraceptive effect of IMPLANON is
achieved by suppression of ovulation,
increased viscosity of the cervical mucus, and
alterations in the endometrium.
• REFERENCE Prescribing Information.
Mechanism of Action, p. 24.
http://www.merck.com/product/usa/pi_circular
s/i/implanon/implanon_pi.pdf
• CONCLUSION Abortifacent
7. Etonogestrel+ Ethinylestradiol
(Nuvaring)
• Although the primary effect of this action is inhibition
of ovulation, other alterations include changes in the
cervical mucus (which increase the difficulty of sperm
entry into the uterus) and the endometrium (which
reduce the likelihood of implantation)
• REFERENCE Prescribing Information. Mechanism of
Action, p. 16.
http://www.merck.com/product/usa/pi_circulars/n/nu
varing/nuvaring_pi.pdf
• CONCLUSION Abortifacent
8. Gestodene + Ethinylestradiol
(Sophia,Meliane, Gynera)
• Femodene tablets contain two active ingredients, ethinylestradiol and gestodene.
These are synthetic versions of the naturally occurring female sex hormones,
oestrogen and progesterone. Ethinylestradiol is a synthetic version of oestrogen
and gestodene is a 'third generation' synthetic form of progesterone.
• Combined oral contraceptives like Femodene work by over-riding the normal
menstrual cycle. In a woman's normal menstrual cycle, levels of the sex hormones
change throughout each month. The hormones cause an egg to be released from
the ovaries (ovulation) and prepare the lining of the womb for a possible
pregnancy. At the end of each cycle, if the egg has not been fertilised the levels of
the hormones fall, causing the womb lining to be shed as a monthly period.
• The daily dose of hormones taken in the pill work mainly by tricking your body into
thinking that ovulation has already happened. This prevents an egg from ripening
and being released from the ovaries each month.
• The hormones also increase the thickness of the natural mucus at the neck of the
womb, which makes it more difficult for sperm to cross from the vagina into the
womb and reach an egg. They also change the quality of the womb lining
(endometrium), making it less likely that a fertilised egg can implant there.
• REFERENCE Femodene. http://www.netdoctor.co.uk/medicines/sexual-
health/a6712/femodene-ethinylestradiol-and-gestodene/
• CONCLUSION Abortifacent
9. Levonorgestrel (Mirena)
• Studies of Mirena and similar LNG IUS prototypes have
suggested several mechanisms that prevent pregnancy:
thickening of cervical mucus preventing passage of
sperm into the uterus, inhibition of sperm capacitation
or survival, and alteration of the endometrium.
• REFERENCE Prescribing Information. Mechanism of
Action, p. 19.
https://labeling.bayerhealthcare.com/html/products/pi/
Mirena_PI.pdf
• CONCLUSION Abortifacient
10. Levonorgestrel + Ethinylestradiol
(Juliiane, Nordette, Lady, Denise,
Minipil,Seif, Logynon 21)
• Combination oral contraceptives act by suppression of
gonadotrophins. Although the primary mechanism of
this action is inhibition of ovulation, other alterations
include changes in the cervical mucus (which increase
the difficulty of sperm entry into the uterus) and the
endometrium (which may reduce the likelihood of
implantation).
• REFERENCE http://www.rxlist.com/levora-
drug/patient-images-side-effects.htm
• CONCLUSION Abortifacient
11. Levonorgestrel+ Ethinylestradiol +
Ferrous fumarate
(Protec, Famila 28F, Femme, Ruby,
Trust Pill, Charlize)
• The mechanism is the same as above. Ferrous sulfate is simply
added as an iron supplement.
• Combination oral contraceptives act by suppression of
gonadotrophins. Although the primary mechanism of this action is
inhibition of ovulation, other alterations include changes in the
cervical mucus (which increase the difficulty of sperm entry into the
uterus) and the endometrium (which may reduce the likelihood of
implantation).
• REFERENCE http://www.rxlist.com/levora-drug/patient-images-
side-effects.htm
• CONCLUSION Abortifacient
12. Lynestrenol (Exluton, Daphne, Leila)
• In 10 women taking 0.5 mg lynestrenol for oral contraception
endometrium biopsies were carried out in several consecutive cycles
between the 21st and 25th day of each cycle. In addition pregnandiol
excretion in the urine was measured in one of the last three treatment
cycles always on the 10th and 21st day of cycle. During treatment of a
characteristic, monomorphic microscopical endometrium picture was
observed with hardly distinct endometrium glands and only slight
decidualike transformation of cellular elements of the stroma. From these
histological pictures it is concluded that oral application of 0,5 mg
lynestrenol produces endometrium changes characterized by insufficient
transformation so that nidation of a blastocyte becomes impossible.
• REFERENCE Gerber E, Koch P; [Effects of low doses of lynestrenol on
endometrium and nidation (author's transl)]. Med Klin 71 (2): 51-5 (1976)
https://www.ncbi.nlm.nih.gov/pubmed/1246215?dopt=Abstract
• CONCLUSION Abortifacient
13. Medroxyprogesterone acetate
(Depo-gestin, Depofemme, Depotrust,
Lyndavel, Protec)
• Results of studies conducted using medroxyprogesterone
acetate for marketed indications showed it to be a potent inhibitor of
gonadotropins 1-3 and that it was slowly absorbed from the injection
site resulting in prolonged activity. Furthermore, continued use of the
drug results in endometrial suppression producing an environment
hostile to nidation.
REFERENCE Schwallie, P. and Assenzo, JR. Contraceptive use efficacy
study utilizing Medroxyprogesterone acetate* administered as an
intramuscular injection once every 90 days.” Fertility and Sterility. 25
(5): 331 (1973).
http://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-
S0015028216396698/first-page-pdf
• CONCLUSION Abortifacient
14. Nomegestrol acetate+ Estradiol (as
hemihydrate) (Zoely)
• The contraceptive effect of birth control pills derives primarily from
the progestin component, while the estrogen component
contributes cycle control and potentiates contraceptive efficacy.
The progestin contraceptive effects of NOMAC include
antigonadotropin activity (suppression of the luteinizing and
follicle-stimulating hormone surges that lead to follicle
development and ovulation); thickening of cervical mucus; and
thinning of the endometrium .
• REFERENCE Burke, Anne. “Nomegestrol Acetate-17b-Estradiol for
Oral Contraception.” Patient preference and adherence 7 (2013):
607–619. PMC. Web. 14 Sept. 2017.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702550/#__sec2t
itle
• CONCLUSION Abortifacient
15. Norethisterone Enanthate + Estradiol valerate
(Norifam)
Norethisterone+ Ethinylestradiol (Micropill)
Norethisterone+ Ethinylestradiol + Ferrous
fumarate (Micropill Plus)
• The principal distinctions between DMPA and NET-EN are their durations of effectiveness and the
incidence of drug-induced amenorrhea, and little else typically determines prescriptive practice.
Nonetheless, given slight differences in the steroid derivation of the two drugs, experience of
different side-effects with the two methods (e.g., weight gain or hirsutism), cannot be ruled out;
however, most comparative data show few clinical differences other than duration of action…
Current formulations of injectable contraceptives are highly effective. One injection of DMPA
inhibits ovulation for 14 weeks, suppressing both FSH and LH. Cervical mucus is thickened,
decreasing sperm penetration, the endometrium is atrophied with inactive glands, and there is
decreased tubal motility. Pregnancies due to method failure are consistently low, with cumulative
life-table rates of 0-0.1 percent at 12 months. NET-EN is also highly effective. When given at 60-day
intervals, the cumulative lifetable rates are 0.4% at 12 months, and 0.4% at 24 months.
• REFERENCE Injectable Contraceptives for Women. Adapted from: d'Arcangues C, Snow R. Injectable
contraceptives. In: Rabe T, Runnebaum B, eds. Fertility Control-Update and Trends. Springer-Verlag
Berlin 1999: 121-149. http://www.gfmer.ch/Endo/Course2003/Injectable_contraceptives.htm
• CONCLUSION Same as medroxyprogesterone acetate (DPMA); abortifacient
16. Copper Intrauterine Device
(Securit-T)
• All IUDs induce a local inflammatory reaction that disturbs the
functioning of the endometrium and myometrium and changes the
microenvironment of the uterine cavity. Moreover, these effects
alter signaling between uterus and ovary. The entire genital tract
seems affected, at least in part because of luminal transmission of
fluids accumulating in the uterine lumen. Copper or progesterone-
releasing IUDs may attenuate or accentuate the inflammatory
response, disturb the physiology of the gametes in the female
genital tract, or destroy the viability of the embryos or endometrial
receptivity to implantation.
• REFERENCE Ortiz ME1, Croxatto HB, Bardin CW. Mechanisms of
action of intrauterine devices. Obstet Gynecol Surv. 1996 Dec;51(12
Suppl):S42-51.
https://www.ncbi.nlm.nih.gov/pubmed/8972502
• CONCLUSION Abortifacient