In vivo assessment of the human sperm acrosome reaction and the expression of glycodelin-A in human endometrium after levonorgestrel-emergency contraceptive pill administration

• Published in: Human reproduction (Oxford) 2007-08, Vol.22 (8), p.2190-2195
• Main Authors: do Nascimento, Josiane A.A., Seppala, Markku, Perdigão, Antero, Espejo-Arce, Ximena, Munuce, Maria José, Hautala, Laura, Koistinen, Riitta, Andrade, Liliana, Bahamondes, Luis
• Format: Article
• Language: English
• Subjects: acrosome reaction; Acrosome Reaction - physiology; Adult; Biological and medical sciences; Contraception, Postcoital; Contraceptives, Postcoital, Synthetic - administration & dosage; Double-Blind Method; emergency contraception; Endometrium - drug effects; Endometrium - metabolism; Female; Glycodelin; glycodelin-A; Glycoproteins - biosynthesis; Gynecology. Andrology. Obstetrics; human spermatozoa; Humans; levonorgestrel; Levonorgestrel - administration & dosage; Levonorgestrel - blood; Male; Medical sciences; Pregnancy Proteins - biosynthesis
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/humrep/dem119

BACKGROUND The objectives were firstly to assess acrosome reaction (AR) status of spermatozoa following uterine flushing, secondly to measure levonorgestrel (LNG) levels in serum and in uterine flushing fluid and finally to measure endometrial glycodelin-A expression after administration of LNG as a form of emergency contraception (EC). METHODS Forty-eight experiments were conducted on 15 regularly menstruating women. Four groups were formed based on different intercourse to treatment interval and treatment to recovery of spermatozoa and the biopsies. RESULTS Twenty-four and forty-eight hours after treatment, there were 14.5 ± 3.9 × 106 and 17.3 ± 6.8 × 106 sperm recovered from the uterus, respectively. There were no differences between the AR rate and the endometrial glycodelin-A staining intensity in an LNG or placebo treated cycles. The LNG in uterine flushing medium represented 1.38% of the values observed in serum 24 h after the LNG intake. CONCLUSIONS Twenty-four and forty-eight hours after administration of EC, neither the proportion of AR sperm, nor the glycodelin-A level was influenced by 1.5 mg of LNG. LNG did not impair the cervical mucus either because viable spermatozoa were found in the genital tract 36–60 h after coitus and 24–48 h after LNG intake. The mechanism of action of LNG as EC remains unknown.