Serum levonorgestrel concentration and cervical mucus viscosity after six months of monoplant® implantation

  • Eka R. Gunardi Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
  • Biran Affandi Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
DOI: https://doi.org/10.13181/mji.v23i1.685
Keywords: cervical mucus viscosity, implant monoplant®, serum levonorgestrel
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Abstract

Background: The use of levonorgestrel implants as a contraceptive method have undergone changes in the number of implants used, beginning from six rods in the early methods to two rods in the present method and have been proven effective. This study aims to evaluate the efficacy of single rod implant (Monoplant®) by measuring serum levonorgestrel concentration and cervical mucus quality.

Methods: Thirty healthy women, aged 20-40 year old, and have been proven fertile, underwent single rod implant insertion. Levonorgestrel serum levels was measured every month and cervical mucus viscosity was examined every three month, until six months.

Results: Levonorgestrel serum concentration was consistently above minimum effective level (200 pg/mL), from month 3 to 6 respectively 338.9 pg/mL, 424.8 pg/mL, 320.3 pg/mL, and 337.5 pg/mL. Almost all of the acceptors (96.7%) had good cervical mucus viscosity since three months following implant insertion.

Conclusion: Levonorgestrel serum concentration in Monoplant® users was still above minimum contraceptive level until the sixth month. Viscosity of cervical mucus increased immediately following implant insertion. This indicates that single rod levonorgestrel implant is effective as a contraceptive method.

Keywords: cervical mucus viscosity, implant monoplant®, serum levonorgestrel

References

  1. Affandi B, Santoso SS, Djajadilaga, Hadisaputra W, Moeloek FA, Prihartono J, et al. Five-year experience with Norplant. Contraception. 1987;36(4):417-28. http://dx.doi.org/10.1016/0010-7824(87)90090-4

  2. Curtis KM. Safety of implantable contraceptives for women: data from observational studies. Contraception. 2002;65(1):85-96. http://dx.doi.org/10.1016/S0010-7824(01)00291-8

  3. Brown A. Long-term contraceptives. Best Pract Res Clin Obstet Gynaecol. 2010;24(5):617-31. http://dx.doi.org/10.1016/j.bpobgyn.2010.04.005

  4. McDonald-Mosley R, Burke AE. Contraceptive implants. Semin Reprod Med. 2010;28(2):110-7. http://dx.doi.org/10.1055/s-0030-1248135

  5. Davis AR, Westhoff C, O’Connell K, Gallagher N. Oral contraceptives for dysmenorrhea in adolescent girls: a randomized trial. Obstet Gynecol. 2005;106(1):97-104. http://dx.doi.org/10.1097/01.AOG.0000165826.03915.65

  6. Meckstroth KR, Darney PD. Implantable contraception. Obstet Gynecol Clin North Am. 2000;27(4):781-815. http://dx.doi.org/10.1016/S0889-8545(05)70172-8

  7. Brache V, Faundes A, Alvarez F, Garcia AG. Transition from Norplant to Jadelle in a clinic with extensive experience providing contraceptive implants. Contraception. 2006;73(4):364-7. http://dx.doi.org/10.1016/j.contraception.2005.10.015

  8. Affandi B, Wijayanegara H, Permadi W, Soedarto, Hasan M, Ngartjono W et.al [Internet]. Multi centers research comparative study of Indoplant® and Norplant® in Indonesia. 2005 [cited 2013 Oct 7];[5 screen]. Available from: http://www.triyasa.com/prodadd/csini.pdf.

  9. Gunardi ER, Affandi B, Juliaan F. Levonorgestrel concentration in a single rod implant users for six months. Indones J Obstet Gynecol. 2011;35(3):122-7.

  10. Gunardi ER, Affandi B, Muchtar A. Monoplant® the Indonesian implant: the overview of implant and its development. Indones J Obstet Gynecol. 2011;35(1):40-6.

  11. Council P. Norplant® LNG implant: a summary of scientific data. New York (NY): The Population Council; 1990.

  12. Sivin I, Nash H, Waldman S. Jadelle® levonorgestrel rod implants. A summary of scientific data and lessons learned from programmatic experience. New York: Population Council; 2002.

  13. Berek SJ. Berek & Novak’s Gynecology. California: Lippincott Williams & Wilkin; 2007.

  14. Henry M. Williams textbook of endocrinology. Philadelphia: Saunders Elsevier; 2008.

  15. Raudaskoski T, Laatikainen T, Kauppila A. Sex-hormone binding globulin as an indicator of the hepatic impacts of continuous combined hormone replacement regimens. Maturitas. 1998;29(1):87-92. http://dx.doi.org/10.1016/S0378-5122(98)00003-6

  16. Shaaban MM, Segal S, Salem HT, Ghaneimah SA, Khalifa EA, Ahmed AG. Sonographic assessment of ovarian and endometrial changes during long-term Norplant use and their correlation with hormonal levels. Fertil Steril. 1993;59(5):998-1002.

  17. Croxatto HB, Diaz S, Salvatierra AM, Morales P, Ebensperger C, Brandeis A. Treatment with Norplant subdermal implants inhibits sperm penetration through cervical mucus in vitro. Contraception. 1987;36(2):193-201. http://dx.doi.org/10.1016/0010-7824(87)90014-X

  18. Weschler TID. Taking charge of your fertility, 10th ed. the definitive guide to natural birth control, pregnancy achievement, and reproductive health. Harper Collins: United States of America; 2002.

  19. Affandi B. Clinical, pharmacological and epidemiological studies on a levonorgestrel implant contraceptive. Jakarta: University of Indonesia; 1987.

  20. Sivin I, Lahteenmaki P, Ranta S, Darney P, Klaisle C, Wan L, et al. Levonorgestrel concentrations during use of levonorgestrel rod (LNG ROD) implants. Contraception. 1997;55(2):81-5. http://dx.doi.org/10.1016/S0010-7824(96)00276-4

  21. Sivin I, Lahteenmaki P, Mishell DR Jr, Alvarez F, Diaz S, Ranta S, et al. First week drug concentrations in women with levonorgestrel rod or Norplant capsule implants. Contraception. 1997;56(5):317-21. http://dx.doi.org/10.1016/S0010-7824(97)00153-4

  22. Sivin I, Viegas O, Campodonico I, Diaz S, Pavez M, Wan L, et al. Clinical performance of a new two-rod levonorgestrel contraceptive implant: a three-year randomized study with Norplant implants as controls. Contraception. 1997;55(2):73-80. http://dx.doi.org/10.1016/S0010-7824(96)00275-2

  23. Sivin I, Mishell DR Jr, Diaz S, Biswas A, Alvarez F, Darney P, et al. Prolonged effectiveness of Norplant(R) capsule implants: a 7-year study. Contraception. 2000;61(3):187-94. http://dx.doi.org/10.1016/S0010-7824(00)00095-0

  24. Barbosa I, Bakos O, Olsson SE, Odlind V, Johansson ED. Ovarian function during use of a levonorgestrel-releasing IUD. Contraception. 1990;42(1):51-66. http://dx.doi.org/10.1016/0010-7824(90)90092-A

  25. Baziad A. Endocrinologi ginekologi. Edisi Ke 2. Jakarta: Media Aesculapius; 2003. Indonesian.

  26. Lewis RA, Taylor D, Natavio MF, Melamed A, Sokol R, Mishell DR Jr. Effects of the levonorgestrel intrauterine system (LNG-IUS) on cervical mucus quality and sperm penetration. Fertility and Sterility. 2009;92(3, Supplement 1):S27. http://dx.doi.org/10.1016/j.fertnstert.2009.07.104

  27. Jonsson B, Landgren BM, Eneroth P. Effects of various iuds on the composition of cervical mucus. Contraception. 1991;43(5):447-58. http://dx.doi.org/10.1016/0010-7824(91)90135-3

  28. Shi JP, Wu XR. Levonorgestrel levels in serum and uterine flushings in women bearing LNG-Cu-IUD. J Tongji Med Univ. 1993;13(2):126-8. http://dx.doi.org/10.1007/BF02887929

  29. Croxatto HB. Norplant: levonorgestrel-releasing contraceptive implant. Ann Med. 1993;25(2):155-60. http://dx.doi.org/10.3109/07853899309164160

Published
2014-03-11
How to Cite
1.
Gunardi ER, Affandi B. Serum levonorgestrel concentration and cervical mucus viscosity after six months of monoplant® implantation. Med J Indones [Internet]. 2014Mar.11 [cited 2024Apr.25];23(1):25-9. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/685
Issue
Vol. 23 No. 1 (2014): February
Section
Clinical Research

Copyright (c) 2014 Eka R. Gunardi, Biran Affandi

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