Etonogestrel Implant as Emergency Contraception: A Pilot Pharmacodynamic Study
试验速览
- 阶段
- 4 期
- 状态
- 招募中
- 入组人数
- 12
- 试验地点
- 1
- 主要终点
- Ovarian follicle size
研究概览
简要总结
The investigators propose a single site, single arm, open label mechanism of action pharmacodynamic pilot study of etonogestrel implant insertion prior to an luteinizing hormone (LH) surge. The investigators will evaluate ovulation rates via serum levels of reproductive hormones and transvaginal ultrasound findings following placement of an etonogestrel implant once the dominant follicle reaches a size of 15mm or greater, but prior to an LH surge, in persons with prior documented regular cycles and confirmed ovulation. The researchers' hypothesis is that ovulation will be inhibited if the etonogestrel implant is placed prior to an LH surge.
Based on data from the Food and Drug Administration label for Nexplanon, etonogestrel rises to levels associated with ovulation suppression within 8 hours of placement. Given this rapid increase, it is therefore plausible to assume that ovulation can be inhibited by the implant if placed prior to an LH surge. This study is novel as there have been no published studies evaluating an etonogestrel implant for this indication.
The contribution of this proposed research to the literature is significant because current recommendations from the Center for Disease Control (CDC) regarding timing of etonogestrel implant placement are stringent and not patient-centered. Any day insertion of the etonogestrel implant is supported by retrospective data and this pharmacodynamic data would further support the literature for any day insertion without the need for additional emergency contraception. If results support the investigators' hypothesis, it could increase access to contraception and decrease duplicative therapy.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Basic Science
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 40 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •BMI less than or equal to 28kg/m2
- •Intact uterus with at least one ovary
- •Regular menstrual cycles that occur every 21-35 days
- •If patient is postpartum or post-second trimester abortion, 3 menses (2 cycles) must have occurred prior to enrollment
- •If patient had a first trimester abortion or pregnancy loss, she must have one spontaneous menses prior to enrollment
- •Desires insertion of an etonogestrel contraceptive implant for contraception
- •Not currently pregnant or trying to become pregnant
- •Willing to abstain from medications and supplements known to induce/inhibit CYP3A4 during the study
排除标准
- •Have a known hypersensitivity or contraindications to etonogestrel.
- •Medical conditions that affect liver function (e.g., hepatitis, cirrhosis; assessed via participant self-report)
- •Known or suspected current alcohol dependence syndrome or any illicit drug use that may affect the metabolism of the etonogestrel.
- •Uncontrolled thyroid disorder.
- •Use of long-acting injectable hormonal contraceptive within the past 9 months
- •Current use of hormonal oral, patch, intravaginal, or intrauterine contraception
研究组 & 干预措施
Main cohort
Insertion of etonogestrel contraceptive implant prior to LH surge
干预措施: Etonogestrel implant (Drug)
结局指标
主要结局
Ovarian follicle size
时间窗: 7 days
Serial transvaginal ultrasound measurements of the leading or dominant follicle will be conducted after insertion of the etonogestrel implant. Ovulation will be defined by follicle rupture with complete disappearance or at least a 50% reduction in the mean size of the leading follicle.
Serum progesterone
时间窗: 7 days
Serial measurements of serum progesterone will be conducted after insertion of the etonogestrel implant to assess for evidence of potential ovulation (\>3ng/mL)
次要结局
- Luteinizing hormone(7 days)