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Omitting the first oral contraceptive pills of the cycle does not automatically lead to ovulation.
Am J Obstet Gynecol. 1998 Jul; 179(1):41-6.AJ

Abstract

OBJECTIVE

Our purpose was to test the hypothesis that omitting the first three pills of the contraceptive cycle leads to ovulation.

STUDY DESIGN

Ninety-nine women, randomly assigned to 1 of 3 treatments of combined oral contraceptives, completed the study. Treatments contained ethinyl estradiol and either monophasic gestodene, triphasic gestodene, or monophasic desogestrel. Pituitary-ovarian activity was monitored by ultrasonography of the ovaries and assay of serum concentrations of estradiol, progesterone, and follicle-stimulating hormone over 1 normal cycle (study period 1) and 1 cycle after an extended pill-free interval of 10 days (study period 2).

RESULTS

None of the women experienced normal ovulation as evaluated by ultrasonography and serum progesterone concentrations. However, follicle-stimulating hormone reached a maximal serum concentration in most women during the first 7 pill-free days, indicating complete pituitary recovery, and increases in serum estradiol concentrations were seen in each woman although with marked interindividual variation. During study period 2 we found follicles of >18 mm in 24%, 24%, and 40% of the monophasic gestodene, triphasic gestodene, and monophasic desogestrel groups, respectively.

CONCLUSIONS

Follicular growth up to preovulatory size is common in women missing the first one to three pills of their contraceptive cycle. Although this creates the prerequisite for ovulation, normal ovulation did not occur when pill omissions were limited to only 3 days.

Authors+Show Affiliations

Väestöliitto, The Family Federation of Finland, Helsinki.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9704763

Citation

Elomaa, K, et al. "Omitting the First Oral Contraceptive Pills of the Cycle Does Not Automatically Lead to Ovulation." American Journal of Obstetrics and Gynecology, vol. 179, no. 1, 1998, pp. 41-6.
Elomaa K, Rolland R, Brosens I, et al. Omitting the first oral contraceptive pills of the cycle does not automatically lead to ovulation. Am J Obstet Gynecol. 1998;179(1):41-6.
Elomaa, K., Rolland, R., Brosens, I., Moorrees, M., Deprest, J., Tuominen, J., & Lähteenmäki, P. (1998). Omitting the first oral contraceptive pills of the cycle does not automatically lead to ovulation. American Journal of Obstetrics and Gynecology, 179(1), 41-6.
Elomaa K, et al. Omitting the First Oral Contraceptive Pills of the Cycle Does Not Automatically Lead to Ovulation. Am J Obstet Gynecol. 1998;179(1):41-6. PubMed PMID: 9704763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Omitting the first oral contraceptive pills of the cycle does not automatically lead to ovulation. AU - Elomaa,K, AU - Rolland,R, AU - Brosens,I, AU - Moorrees,M, AU - Deprest,J, AU - Tuominen,J, AU - Lähteenmäki,P, PY - 1998/8/15/pubmed PY - 1998/8/15/medline PY - 1998/8/15/entrez KW - Behavior KW - Belgium KW - Clinical Research KW - Contraception KW - Contraceptive Agents, Estrogen--administraction and dosage KW - Contraceptive Agents, Female--administraction and dosage KW - Contraceptive Agents, Progestin--administraction and dosage KW - Contraceptive Agents--administraction and dosage KW - Contraceptive Methods--administraction and dosage KW - Desogestrel--administraction and dosage KW - Developed Countries KW - Ethinyl Estradiol--administraction and dosage KW - Europe KW - Family Planning KW - Finland KW - Gestodene--administraction and dosage KW - Netherlands KW - Northern Europe KW - Oral Contraceptives, Combined--administraction and dosage KW - Oral Contraceptives--administraction and dosage KW - Ovulation KW - Reproduction KW - Research Methodology KW - Research Report KW - Scandinavia KW - User Compliance KW - Western Europe SP - 41 EP - 6 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 179 IS - 1 N2 - OBJECTIVE: Our purpose was to test the hypothesis that omitting the first three pills of the contraceptive cycle leads to ovulation. STUDY DESIGN: Ninety-nine women, randomly assigned to 1 of 3 treatments of combined oral contraceptives, completed the study. Treatments contained ethinyl estradiol and either monophasic gestodene, triphasic gestodene, or monophasic desogestrel. Pituitary-ovarian activity was monitored by ultrasonography of the ovaries and assay of serum concentrations of estradiol, progesterone, and follicle-stimulating hormone over 1 normal cycle (study period 1) and 1 cycle after an extended pill-free interval of 10 days (study period 2). RESULTS: None of the women experienced normal ovulation as evaluated by ultrasonography and serum progesterone concentrations. However, follicle-stimulating hormone reached a maximal serum concentration in most women during the first 7 pill-free days, indicating complete pituitary recovery, and increases in serum estradiol concentrations were seen in each woman although with marked interindividual variation. During study period 2 we found follicles of >18 mm in 24%, 24%, and 40% of the monophasic gestodene, triphasic gestodene, and monophasic desogestrel groups, respectively. CONCLUSIONS: Follicular growth up to preovulatory size is common in women missing the first one to three pills of their contraceptive cycle. Although this creates the prerequisite for ovulation, normal ovulation did not occur when pill omissions were limited to only 3 days. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/9704763/Omitting_the_first_oral_contraceptive_pills_of_the_cycle_does_not_automatically_lead_to_ovulation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002937898702492 DB - PRIME DP - Unbound Medicine ER -