Journal of Contraception Reproductive Health Care - The European ...

The 8th Congress of The European Society of Contraception Abstracts of Free Communications
FC4-04
Can we trust symptoms?
P.-A. Ma˚rdh
Department of Obstetrics and Gynecology, Lund University, Lund, Sweden
Introduction: It is a common experience among gynaecologists that there is often a discrepancy between symptoms and signs
with regard to diseases affecting the lower genital tract (LGTI), for example.
Objectives: To correlate symptoms reported by women who had attended for contraceptive advice and in whom laboratory
findings either documented or could not document presence of a lower genital tract infection with the outcome of an experimental
psychological personality profile survey of these women.
Aims and Methods: One thousand women were studied with an extensive battery of microbiological tests for bacterial, fungal,
viral and parasitic genital infections and for vaginal flora changes such in vulvovaginal candidiasis and bacterial vaginosis. The
participants were asked to react on a series of pictures with a given number of alternatives to box graded from do not agree
with statement to agree very much. The Sivik’s test, which we used, had been validated in a large population-based survey.
Results: The women who were infected were, as compared to those who were microbiologically negative, showed, e.g. a higher
proneness to trust other persons (p=0.04), had a lower ability to feel guilt and shame (p=0.01) and were less aggressive (p=0.01).
The infected women with no symptoms compared to those infected who could report symptoms showed less proneness to
experience anxiety (p=0.04), had a higher tendency to expect and/or demand anything from other people (p=0.05).
Conclusions: Symptoms, regarded as indicative of a LGTI, reported by a woman at history taking are strongly influenced by her
personality profile. This profile may also influence her risking taking in general, including her risk of contracting exogenous
genital infectious agents.
FC4-05
Maintenance of spermatogenic suppression by etonogestrel implants with depot testosterone
M. Walton (1), B. Brady (1), D.T. Baird (1), R.A. Anderson (2)
Contraceptive Development Network, Edinburgh, UK (1); MRC Human Reproductive Sciences Unit, Centre for Reproductive Biology,
University of Edinburgh, UK
Objective: Testosterone/progestogen combinations are currently the most promising approach to hormonal male contraception.
We here investigated the effectiveness of the etonogestrel implant Implanon 1 in combination with androgen replacement using
testosterone pellets in maintaining spermatogenic suppression. We have recently demonstrated that this combination results in
profound but incomplete suppression of spermatogenesis with only 1/14 men maintaining a sperm concentration 40.1610 6 /ml
after 24 weeks treatment with 2 etonogestrel implants. We here investigated the effects of a higher dose of etonogestrel, i.e. 3
implants at maintaining spermatogenic suppression for a longer time period of up to 48 weeks.
Methods: Fifteen healthy men received 3 subcutaneous etonogestrel implants (each releasing approximately 50 mg/day) with
400mg testosterone pellets s. c. 12- weekly for 24 or 48 weeks. Semen analysis was performed at 4 weekly intervals.
Results: 13 of 15 men completed 24 weeks treatment. Sperm concentrations were reduced to 51610 6 /ml in all 14 subjects at
week 16. Azoospermia was achieved in 10/14 subjects at week 16 and 10/13 subjects at week 24. 9 men chose to continue
treatment to a total of 48 weeks. 8 men remained consistently azoospermic from week 28, but one showed partial recovery of
spermatogenesis from week 40, sperm concentration increasing from azoospermia to 7610 6 /ml. This was associated with partial
escape from suppression of FSH. LH remained suppressed to the limit of detection in all men. Mean testosterone concentrations
remained in the normal range throughout the study.
Conclusion: In comparison to 2 etonogestrel implants with testosterone pellets, the addition of a third provides more consistent
profound suppression of gonadotrophins and spermatogenesis. This regimen therefore illustrates the potential for long-acting
hormonal male contraception, although the duration of action remains to be more completely defined.
This study was supported by DFID/MRC (grant no G9523250).
42 The European Journal of Contraception and Reproductive Health Care