UPA and LNG in emergency contraception: the information by EMA and the scientific evidences indicate a prevalent anti-implantation effect.
Eur J Contracept Reprod Health Care
; 24(1): 4-10, 2019 Feb.
Article
em En
| MEDLINE
| ID: mdl-30656992
ABSTRACT
RATIONALE AND OBJECTIVES:
Emergency contraceptives pills (ECPs) are described as drugs that work by either inhibiting or delaying ovulation without affecting implantation. In our opinion, as we aim at demonstrating, both EMA documents and the experimental papers indicate that they prevalently inhibit embryo-implantation. LNG-ECPs literature LNG-ECPs never prevent ovulation when are taken in the most fertile days (EMA-EPAR on ellaOne® p. 9, first table). Conversely, they prevent the formation of an adequate corpus luteum. When they are taken pre-ovulatory ovulations occur regularly, but pregnancies do not appear. Taken after ovulation, they seem ineffective in preventing pregnancies. UPA-ECPs literature EllaOne® prevents ovulation only when is taken in the first fertile day. Thereafter, its anti-ovulatory effect drops sharply and becomes insignificant (8%) 36 h before ovulation, in the most fertile days (Brache); its decreasing anti-ovulatory effect cannot explain a consistently high effectiveness in preventing pregnancies (≥80%) that does not decrease depending on which of the 5 d it is taken after unprotected intercourse. Besides, ovulation occurs regularly in 91.7% of women taking ellaOne® weekly, for eight consecutive weeks (EMA-CHMP-Assessment Report 'EMA/73099/2015' study HRA2914-554, p. 7). Lastly, Lira-Albarrán administered ellaOne® to women in the most fertile pre-ovulatory days they had normal ovulation, but their endometrium, evaluated through samples obtained in the implantation window, became inhospitable the expression of 1183 genes was exactly the opposite of that observed in the receptive pro-gestational endometrium. This agrees with information by EMA-CHMP-Assessment Report 'EMEA/261787/2009' (p. 8) after UPA administration 'the proteins necessary to begin and maintain pregnancy are not synthesized'.CONCLUSIONS:
Emergency Contraceptives work prevalently by preventing embryo-implantation. People shall receive correct information.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Implantação do Embrião
/
Levanogestrel
/
Anticoncepcionais Orais
/
Anticoncepcionais Pós-Coito
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Eur J Contracept Reprod Health Care
Assunto da revista:
MEDICINA REPRODUTIVA
/
SERVICOS DE PLANEJAMENTO FAMILIAR
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Itália