This month’s featured editorial

Bringing research to life: a collaborative partnership dedicated to improving reproductive health care
Wayne C. Shields, Susan Higginbotham
pages 267-268
The Society of Family Planning (SFP) and the Association of Reproductive Health Professionals (ARHP) are two organizations with different but complementary missions. Together, we write this editorial in order to raise awareness of how we work collaboratively, specifically around translating scientific research in family planning and abortion into direct patient care.
As Contraception's two sponsoring organizations, SFP and ARHP represent a productive model for professional partnerships that can address key scientific issues while ultimately helping improve the quality of care. Academic societies like SFP, through their support for evidence-based research and development of practice guidelines, can enhance the effectiveness of professional education organizations like ARHP that develop continuing medical education programs and learning environments for health care providers of all disciplines and specialties. Read more

Review Articles

Flexible mifepristone and misoprostol administration interval for first-trimester medical termination
Lilantha Wedisinghe, Deya Elsandabesee
pages 269-274
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Clinical pharmacokinetics and interaction of centchroman — A mini review
Jawahar Lal
pages 275-280
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Original research articles

Recovery of bone mineral density in adolescents following the use of depot medroxyprogesterone acetate contraceptive injections
Zeev Harel, Christine Cole Johnson, Melanie A. Gold, Barbara Cromer, Edward Peterson, Ronald Burkman, Margaret Stager, Robert Brown, Ann Bruner, Susan Coupey, Paige Hertweck, Henry Bone, Kevin Wolter, Anita Nelson, Sharon Marshall, Laura K. Bachrach
pages 281-291
Background: Depot medroxyprogesterone acetate (DMPA) is a highly effective progestin-only contraceptive that is widely used by adolescents. We investigated bone mineral density (BMD) changes in female adolescents during and following use of this method.
Conclusions: BMD loss in female adolescents receiving DMPA for contraception is substantially or fully reversible in most girls following discontinuation of DMPA, with faster recovery at the LS than at the hip.
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Health care providers' knowledge about contraceptive evidence: a barrier to quality family planning care?
Christine Dehlendorf, Kira Levy, Rachel Ruskin, Jody Steinauer
pages 292-298
Background: The underuse of effective contraceptive methods by women at risk for unintended pregnancy is a major factor contributing to the high rate of unintended pregnancy in the United States. As health care providers are important contributors to women's contraceptive use, this study was conducted to assess provider knowledge about contraception.
Conclusions: The lack of consistent and accurate knowledge about contraception among providers has the potential to dramatically affect providers' ability to provide quality contraceptive care for their patients, which could have an impact on their ability to prevent unintended pregnancies.
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Correlates of use of long-acting reversible methods of contraception among adolescent and young adult women
Amy K. Whitaker, Annie M. Dude, Amy Neustadt, Melissa L. Gilliam
pages 299-303
Background: Most pregnancies among adolescent and young adult women are unintended, and adolescent birth rates have risen. Use of long-acting reversible contraception may be an effective strategy to reduce the rate of unintended pregnancy.
Conclusions: While similarities exist between the correlates of use of DMPA and the IUD, we discovered important differences, some of which may reflect provider biases regarding IUD provision.
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Cost–benefit analysis of state- and hospital-funded postpartum intrauterine contraception at a university hospital for recent immigrants to the United States
Maria Isabel Rodriguez, Aaron B. Caughey, Alison Edelman, Philip D. Darney, Diana Greene Foster
pages 304-308
Objective: To examine the hospital and state costs of offering the option of a postpartum intrauterine device (IUD) to an underinsured population of recent immigrants to the United States with Emergency Medicaid (EM) insurance coverage only.
Conclusion: Considering only the direct costs associated with a repeat pregnancy, a program offering the option of postpartum IUD placement to underinsured women would significantly reduce state expenditures on subsequent pregnancies.
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Effect of low-dose combined oral contraceptive on aerobic capacity and anaerobic threshold level in active and sedentary young women
Ana Cristina S. Rebelo, Roberta S. Zuttin, Rozangela Verlengia, Marcelo de C. Cesar, Marcos Felipe Silva de Sá, Ester da Silva
pages 309-315
Background: The purpose of this study was to evaluate the effect of long-term use of oral contraceptives (OC) containing 0.20 mg of ethinylestradiol (EE) combined with 0.15 mg of gestodene (GEST) on the peak aerobic capacity and at the anaerobic threshold (AT) level in active and sedentary young women.
Conclusions: Long-term use of OC containing EE 0.20 mg plus GEST 0.15 mg does not affect aerobic capacity at the peak and at the AT level of exercise tests.
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Pregnancy coercion, intimate partner violence and unintended pregnancy
Elizabeth Miller, Michele R. Decker, Heather L. McCauley, Daniel J. Tancredi, Rebecca R. Levenson, Jeffrey Waldman, Phyllis Schoenwald, Jay G. Silverman
pages 316-322
Background: Reproductive control including pregnancy coercion (coercion by male partners to become pregnant) and birth control sabotage (partner interference with contraception) may be associated with partner violence and risk for unintended pregnancy among young adult females utilizing family planning clinic services.
Conclusions: Pregnancy coercion and birth control sabotage are common among young women utilizing family planning clinics, and in the context of partner violence, are associated with increased risk for unintended pregnancy.
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Two medical abortion regimens for late first-trimester termination of pregnancy: a prospective randomized trial
Chelly Dalenda, Najar Ines, Boudaya Fathia, Affes Malika, Zouaoui Bechir, Sfar Ezzeddine, Chelly Hela, Channoufi Mohamed Badis
pages 323-327
Background: Medical abortion regimens based on the use of either misoprostol alone or in association with mifepristone have shown high efficacy and excellent safety profile in early pregnancy abortion. However, no clear recommendation is available for late first-trimester termination of pregnancy.
Conclusion: For late first-trimester termination, a single 800-mcg vaginal dose of misoprostol seems to be as effective as the mifepristone+misoprostol regimen, with acceptable side effects.
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Relationship of intraamniotic digoxin to fetal demise
Lynn Borgatta, Sarah J. Betstadt, Ann Reed, Kui-tzu Feng
pages 328-330
Background: Induced fetal demise by intraamniotic injection of digoxin is an alternative to methods using intracardiac or umbilical vein injection. This study was designed to evaluate the effectiveness of intraamniotic injection and the timing of fetal demise after injection.
Conclusion: Intraamniotic injection of digoxin 1.5 mg is effective at causing fetal demise by 20 to 24 h. However, for most women, fetal demise is not obtained within 4 h.
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Can Lactobacillus acidophilus influence the adhesion capacity of Candida albicans on the combined contraceptive vaginal ring?
Francieli Chassot, Daiane P. Camacho, Eliana Valéria Patussi, Lucélia Donatti, Terezinha I.E. Svidzinski, Márcia E.L. Consolaro
pages 331-335
Background: This study was conducted to evaluate the influence of Lactobacillus acidophilus on the adhesion capacity of Candida albicans on the combined contraceptive vaginal ring (CCVR).
Conclusions: If these findings correlated with the conditions in vivo, the use of probiotics based on L. acidophilus or its presence in the vaginal microbiota would not protect against the adhesion of C. albicans to the ring.
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Intrauterine administration of CDB-2914 (Ulipristal) suppresses the endometrium of rhesus macaques
Robert M. Brenner, Ov D. Slayden, Anita Nath, Y.Y. Tsong, Regine Sitruk-Ware
pages 336-342
Background: Ulipristal (UPA; CDB-2914) is a progesterone receptor modulator with contraceptive potential. To test its effects when delivered by an intrauterine system (IUS), we prepared control and UPA-filled IUS and evaluated their effects in rhesus macaques.
Conclusions: In rhesus macaques, a UPA-IUS induced endometrial atrophy and amenorrhea. The work provides proof of principle that an IUS can deliver effective intrauterine concentrations of Ulipristal.
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Does over-exposure to copper ions released from metallic copper induce cytotoxic and genotoxic effects on mammalian cells?
Claudia A. Grillo, Miguel A. Reigosa, Mónica A. Fernández Lorenzo de Mele
pages 343-349
Background: A high dissolution of copper from intrauterine devices (IUDs) occurs during the first days after insertion. This work is focused on the assessment of the possible cyto- and genotoxic effects of different concentrations of copper ions released from metallic copper on mammalian cells in vitro.
Conclusion: Our results demonstrate cytotoxic and genotoxic effects of copper ions released from metallic copper on CHO-K1 cells and emphasize the importance of reducing the initial copper dissolution from IUD without affecting the contraceptive action.
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Initial studies on a novel filtering-type intra-vas device in male dogs
Xun-bin Huang, Jin-ping Suo, Chun-you Chen, Qing-ling Du, Ji-yun Shen, Jie-ling Zhou
pages 350-354
Background: To relieve the side effects induced by the complete obstruction of the vas deferens, we created a filtering-type intra-vas device (IVD) which is made of materials composed of nano-SiO2-copper complex cross-linking polymer composites.
Conclusions: The filtering-type nano-SiO2-copper complex/polymer composite IVD is able to filter the sperm of the male dogs, and the IVD material did not cause obvious damage to the cells of the male reproductive organs after 1 year of implantation.
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Comparative study on the spermicidal activity of organic solvent fractions from hydroethanolic extracts of Achyranthes aspera and Stephania hernandifolia in human and rat sperm
Daniel Paul, Debasis De, Kazi Monjur Ali, Kausik Chatterjee, Dilip K. Nandi, Debidas Ghosh
pages 355-361
Background: This study was conducted to determine the most effective fraction of the hydroethanolic (water:ethanol, 1:1) extracts of Stephania hernandifolia leaves and Achyranthes aspera roots (in a composite manner at a ratio of 1:3, respectively) that will provide maximum spermicidal activity in human and rat spermatozoa out of five different ratios (1:1, 1:3, 1:7, 3:1 and 7:1) that have been studied in pilot experiments.
Conclusion: The findings indicate that, among the different fractions, the hexane fraction of the hydroethanolic extracts of the two plants produced the most effective spermicidal activity and can be considered as vaginal contraceptive.
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