Effect of long-term triphasic oral contraceptive use on glucose tolerance and insulin secretion

Article Abstract:

Oral contraceptive (OC) use by women can influence and alter their carbohydrate metabolism. These alterations can include glucose intolerance, or abnormal metabolism of glucose, and hyperinsulinemia, or too much insulin, both of which are associated with an increased risk for cardiovascular disease and death. A study found that glucose tolerance affects 15.4 percent of all OC users, but only 6.3 percent of nonusers. Modifications in OC therapy have been made to try and reduce alterations in carbohydrate metabolism. These involve low-dose estrogen-progestin regimens that are triphasic (have three phases). This study examined the effects of two low-dose triphasic regimens on glucose metabolism. Fifty-seven women were randomly assigned to one of the two triphasic OC treatment groups, while 10 women received nonhormonal placebo. Glucose tolerance tests (GTT) were performed at various times during the study. Twenty-seven women received levonorgestrel, 30 received norethindrone, and 10 were in the control group. GTT results showed that at 6 and 12 months after beginning therapy, fasting glucose levels were increased in the two groups receiving triphasic OCs. Insulin responses also increased in both groups at 6 and 12 months. For the levonorgestrel group, they increased from 297 to 356 and 362 milligrams per deciliter at 3 hours (mg/dL/3) hours at 0, 6, and 12 months, respectively. For the norethindrone group they increased from 304 to 344 and 348 mg/dL/3 hours at 0, 6, and 12 months, respectively. However, all the changes are in the normal reference ranges and not within those associated with diabetes. In addition, the changes are not at a level associated with increased risk for cardiovascular disease. The results indicate that both levonorgestrel and norethindrone represent safer alternatives to traditional OCs regarding alterations in carbohydrate metabolism. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Oral contraceptives, Glucose metabolism, Insulin, Levonorgestrel, Norethindrone

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Fertility rates in men with normal semen characteristics: spermatozoal testing by induction of the acrosome reaction and Wright-Giemsa staining for subtle abnormal forms

Article Abstract:

Male fertility is commonly studied in infertile couples. Infertility issues include such semen abnormalities as: reduced volume, reduced density or reduced motility.The fertility potential of men with normal semen has been less extensively characterized. Research has shown correlations between spermatozoal motility (the proportion of moving sperm in a sample) and the proportion of sperm with normal shape with successful egg fertilization under laboratory conditions. To better understand the importance of sperm characteristics for fertilization in real life, the outcome of assisted conception (artificial insemination) using normal donor sperm was evaluated. Twenty-six donors were ranked (as having high or low fertility) according to pregnancy outcome after 1,519 insemination cycles using women with no apparent infertility factors or women with (corrected) ovulatory dysfunction. Pregnancy resulted from insemination with the sperm of 21 donors; the sperm of 5 did not result in pregnancy. The highest pregnancy rate per individual donor was 31 percent of attempted cycles. The number of motile sperm correlated significantly with the pregnancy rate. When motility and the proportion of abnormal sperm forms were combined, abnormal forms were associated with a failure to conceive. More sperm from the high- than the low-fertility group displayed the acrosome reaction (necessary for egg penetration by sperm). The study shows that fertility potential varies among men even when they have met accepted quality for semen donation. Defects in the acrosome reaction may account for unexplained male infertility, and insemination using sperm with optimal characteristics may improve the fertilization rate in some infertile couples. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Spermatozoa, Infertility, Male, Sperm, Male infertility

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