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Levonorgestrel as emergency contraceptive and its influence upon some sperm functions

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Author(s):
Alexia Hermanny
Total Authors: 1
Document type: Doctoral Thesis
Press: Campinas, SP.
Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
Defense date:
Examining board members:
Luis Guillermo Bahamondes; Ilza Maria Urbano Monteiro; Arlete Maria dos Santos Fernandes; Jose Mendes Aldrighi; Cristina Aparecida Falbo Guazzelli
Advisor: Luis Guillermo Bahamondes
Abstract

The mechanism of action of levonorgestrel (LNG) as emergency contraception (EC) is still under debate and the effect upon sperm function is partially explained. The aim of this study was to assess if LNG in a similar dose to those observed in serum after oral intake for EC could affect the spermatozoa when exposed in vitro to human tubes and also to give an overview of the effect of LNG as EC on several sperm functions. Fifteen mini-laparotomies were performed, the ovulatory side was recorded and both tubes were removed and perfused with a suspension of 1x106 of motile spermatozoa, one with LNG and the other without it. After an incubation period of 4hours the tubes were cut to separate the isthmus and the ampulla. Each segment was flushed and the material was evaluated regarding the motile sperm number, the number of spermatozoa adhering to the oviductal epithelium and acrosome reaction (AR) rate. The addition of LNG did not significantly affect the number of recovered spermatozoa neither at the isthmus nor at the ampulla or the number of recovered spermatozoa adhered at the human tubal epithelium. Additionally, LNG did not influence the rate of AR. There were no significant differences even when the ovulatory side was taken into account. The present review showed that there are few studies which focus on the influence of LNG as EC upon sperm functions; albeit it is a plausible mechanism of action. Additionally, the different studies used different methods of evaluation and the results were in many cases contradictories. According to the results observed at the literature, when LNG is used as EC, it is probable that the drug does not achieved sufficient serum concentrations in order to be recognized by the progesterone (P) receptors. Positive results only were observed when the dose of LNG used in the experiments was much higher (comparable to the LNG-IUS) than the proposed for EC. LNG in a similar dose to that observed in serum after oral intake for EC did not affect the number, the adhesion to tubal epithelium, distribution, and AR rate of spermatozoa at the human Fallopian tubes in vitro. According to the results observed at the literature, if the LNG in doses used for EC, affects sperm function or not, it is still uncertain and warrants further studies (AU)

FAPESP's process: 07/07866-2 - Effect of the levonorgestrel as emergency contraceptive on the number, motility and the acrossomal reaction rate of spermatozoa rate recovered from the uterine tuba
Grantee:Alexia Hermanny
Support Opportunities: Scholarships in Brazil - Doctorate