What Is RU <strong>486</strong> <strong>and</strong> How Does It Work?Rather than preventing progesterone receptor activation,they found that RU <strong>486</strong> may work as a cytotoxic agent (acell poison; see also Parinaud et al., 1990; 1537 for a similarresult in human cell culture). This raises a crucial questionfor the use of RU <strong>486</strong> as an abortifacient. If it is a cytotoxicdrug, does RU <strong>486</strong> terminate pregnancies by non-specificcell poisoning? Such an explanation would be far removedfrom the current underst<strong>and</strong>ing of anti-progesterone activity.Another experiment found that the tumor-inhibiting potentialof ZK 112.993 (a Schering drug) was greater than that ofRU <strong>486</strong> (Schneider et al., 1990:683).To end this section on other sites <strong>and</strong> applications of RU<strong>486</strong>, it has also been administered to women on IVFprograms whose pregnancies do not continue (Asch et al.,1990:481). This is the case for 20–40 per cent of womenwho had a successful embryo transfer. After fertility hormonecocktails, hormone monitoring <strong>and</strong> invasive egg harvestingprocedures, they might now be administered yet anotherhazardous chemical: RU <strong>486</strong>.The Effect of RU <strong>486</strong> on Women’s Menstrual Cycles,Fertility, Eggs <strong>and</strong> EmbryosEtienne Baulieu consistently extends the application of RU<strong>486</strong> beyond the drug’s use as an abortifacient to other realmsof female reproduction. As he puts it: ‘RU <strong>486</strong> is a newmedical tool for fertility control’ (1988b: 127). Contraceptionis a case in point. Given at mid-cycle, RU <strong>486</strong> appears todelay ovulation. However, this feature would requirecontinuous administration of the drug which, ‘may beprohibited by the effects of chronically unopposed oestrogenon the endometrium’ (Permezel, 1990:78). In plain English,this means cancer of the endometrium may result, as it haswith unopposed estrogen given to menopausal women.Research to date, aimed at identifying possible uses ofRU <strong>486</strong> as a means of fertility control before or afterovulation, reveals a host of contradictory data. The71
RU <strong>486</strong>complexity of a woman’s menstrual cycle <strong>and</strong> the many finelytuned interactions between ovaries, pituitary <strong>and</strong>hypothalamus are not fully understood. Nonetheless,researchers hope to tame the female reproductive cycle withthe (anti)progesterone concept. Thus ‘normally cyclingwomen’ are recruited for their studies, <strong>and</strong>, as we are assured,after ‘informed consent’ submit their bodies to invasiveprocedures (drug ingestion, frequent blood sampling wi thindwelling intravenous catheter, interference with diet <strong>and</strong>sleep, <strong>and</strong> repeated ultrasound <strong>and</strong> biopsy, etc.). In the nameof science every possible phase of ‘the subject’s’ menstrualcycle is probed <strong>and</strong> the specialist publications proudlyillustrate the effects of RU <strong>486</strong> on the early follicular phase,the late follicular phase, the mid-luteal phase <strong>and</strong> the lateluteal phase (see Stuenkel et al., 1990 for an overview <strong>and</strong>for a particularly harrowing study design). 14The literature often reveals diametrically opposedfindings. The LH surge is delayed in some studies while inothers it is normal; FSH levels are blocked, declined orare the same; hCG levels are significantly elevated (vanSanten <strong>and</strong> Haspels, 1987:436) or inhibited (Das <strong>and</strong> Catt,1987:600). Interpretations vary too, but without exceptionthe papers reveal that RU <strong>486</strong> is poorly understood: ‘Theway in which mifepristone impairs corpus luteum functionis unclear’ (Nieman <strong>and</strong> Loriaux, 1988:613); ‘Whether thisinhibition of gonadotropin [LH/FSH] release was a resultof action at the hypothalamic <strong>and</strong>/or pituitary level isunknown’ (Wolf et al., 1989:185); ‘The exact molecularmechanisms which mediate the negative effects ofantihormones including RU <strong>486</strong> are not yet clear’ (Ortmannet al., 1989:295). Some findings suggest that in addition toits antiprogesterone activities, RU <strong>486</strong> has a progesteronelike(agonist) effect (Collins et al., 1986; Wolf et al., 1987;Parinaud et al., 1990). Other studies found thatadministration of RU <strong>486</strong> without progesterone inhibitedgonadotropin secretion, <strong>and</strong> posit that RU <strong>486</strong> might have72
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Renate Klein is Lecturer in Women
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RU 486Misconceptions,Myths and Mora
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ACKNOWLEDGEMENTSWe would like to ex
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CONTENTSINTRODUCTION 1CHAPTER ONETh
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INTRODUCTIONInitial euphoria greete
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IntroductionUnfortunately, objectio
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Introductiondo not know or do not a
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Introductionused widely for years a
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CHAPTER ONEThe History of RU 486RU
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The History of RU 486consultants ar
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The History of RU 486Events in Fran
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The History of RU 486service of wom
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The History of RU 486The result app
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The History of RU 486developing cou
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Conclusion‘a whole net of relatio
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ENDNOTESChapter One1The paten t lic
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Endnotes12The Journal Officiel publ
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Endnotesin Gynecology and Obstetric
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Endnotesof menses. On the third day
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EndnotesAnother such example is the
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Bibliographyand Segal, Sheldon (Eds
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Bibliographyprostaglandin F 2•. A
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BibliographyDelaney, Anne. (1991, 2
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Bibliographyresponses to the steroi
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Bibliographyabnormalities resulting
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Bibliographyprogesterone receptor b
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BibliographyOdlind, Viveca and Birg
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BibliographyBinding of the anti-pro
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BibliographyUlmann, André, Teutsch
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Bibliographytermination by vacuum a