Contraception最新文献

{"title":"Long-acting reversible contraceptive preference and initiation among clinic-based and telemedicine medication abortion patients at one academic health system in California","authors":"Rebecca Woofter ,&nbsp;Rajita Patil ,&nbsp;May Sudhinaraset ,&nbsp;Jessica Gipson","doi":"10.1016/j.contraception.2025.110838","DOIUrl":"10.1016/j.contraception.2025.110838","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine possible differences in postabortion long-acting reversible contraception (LARC) preference and initiation among clinic-based medication abortion and telemedicine medication abortion patients.</div></div><div><h3>Study design</h3><div>We examined electronic medical records among 576 medication abortion patients at one health system in California between 2020 and 2022.</div></div><div><h3>Results</h3><div>Overall, 25% of patients preferred LARC and 21% initiated LARC. Among those who preferred LARC, 77% initiated LARC. No statistically significant differences were found in LARC preference or initiation across medication abortion modalities.</div></div><div><h3>Conclusions</h3><div>In this health system, clinic-based medication abortion and telemedicine medication abortion patients did not differ in postabortion LARC preference or initiation.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110838"},"PeriodicalIF":2.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical development of a novel injectable hydrogel for vas-occlusion","authors":"Nicholas M. Matsumoto,&nbsp;Tyler G. Chiartas,&nbsp;Benjamin R. Paysour,&nbsp;Timothy J. Barry,&nbsp;Lindsey E. Ott,&nbsp;Yelena Tropsha,&nbsp;Kevin S. Eisenfrats","doi":"10.1016/j.contraception.2025.110839","DOIUrl":"10.1016/j.contraception.2025.110839","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this work is to outline the preclinical development of ADAM, an injectable, two-component polyethylene glycol hydrogel designed for long-lasting and nonpermanent vas-occlusive contraception.</div></div><div><h3>Study design</h3><div>A newly developed hydrogel was comprehensively characterized to evaluate its potential as a male contraceptive device. The material was optimized for porosity to ensure sperm occlusion, rheological properties, injectability, and mechanical durability within the dynamic vessel. Biocompatibility of the hydrogel was assessed using a suite of ISO 10993 tests, which are critical for clinical translation and supporting a future regulatory submission. The canine model was utilized to assess the chronic tissue response of the vas deferens post implantation, providing insights into long-term safety and functionality.</div></div><div><h3>Results</h3><div>The vas-occlusive hydrogel demonstrates selective permeability with a pore size of 10 to 20 nm, effectively preventing sperm passage while allowing diffusion of small molecules. Its mechanical properties facilitated injection into the vas deferens with minimal force (3.1 N), forming a viscoelastic material within 30 seconds, with the ability to resist ejaculatory pressures. The implant and its degradation products were found to be noncytotoxic, nonirritating, nonsensitizing, and nongenotoxic. Moreover, a 2-year in vivo study in a canine model showed minimal tissue reaction following implantation, with no adverse effects reported.</div></div><div><h3>Conclusions</h3><div>These findings indicate that the hydrogel’s chemical and mechanical properties align with the requirements for a safe, effective, and nonpermanent vas-occlusive contraceptive.</div></div><div><h3>Implications</h3><div>Currently, men lack options for effective, long-lasting, and reversible contraception. The development and evaluation of the study hydrogel described here suggest it would make a safe and effective vas-occlusive contraceptive and should be researched further in a clinical setting.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110839"},"PeriodicalIF":2.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do Australian contraceptive users say about their experience of having an intrauterine device inserted? Findings from an online, qualitative survey","authors":"Claire Felix-Faure ,&nbsp;Jacqueline Coombe ,&nbsp;Henrietta Williams ,&nbsp;Cassandra Caddy","doi":"10.1016/j.contraception.2025.110836","DOIUrl":"10.1016/j.contraception.2025.110836","url":null,"abstract":"<div><h3>Objectives</h3><div>We sought to explore contraceptive users’ experiences of the intrauterine device (IUD) insertion in Australia.</div></div><div><h3>Study design</h3><div>We conducted an online qualitative survey with people in Australia, aged 18–45, who had undergone IUD insertion in the last 2 years. We recruited participants using online advertisements on social media and via researcher networks and inductively analysed the data.</div></div><div><h3>Results</h3><div>Of a total 294 recorded responses to our online survey, we included 175 based on completion of selected questions for analysis. Participants’ responses to questions regarding their overall feelings toward their experience of IUD insertion varied greatly. Here, we report on three key themes: <em>preparedness for the procedure, the role of staff and providers, and the role of the non-clinical support person.</em> Those who described being poorly prepared for the pain often reported feeling ‘shocked’ by the experience. Participants reported that support people fostered a sense of safety and served as advocates. Those reporting positive experiences with insertion typically described care that aligned with patient-centered principles.</div></div><div><h3>Conclusions</h3><div>Healthcare providers who insert IUDs should follow clinical guidelines that include guidance on preventing pain and preparing patients for potential pain. Providers can use patient-centered practice to improve patients' experiences of IUD insertion.</div></div><div><h3>Implications</h3><div>These results can be used to improve patient experience of IUD insertion. This work highlights important areas in clinical guidelines requiring review.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110836"},"PeriodicalIF":2.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(25)00011-3","DOIUrl":"10.1016/S0010-7824(25)00011-3","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"143 ","pages":"Article 110820"},"PeriodicalIF":2.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower reporting of venous thromboembolisms events with natural estrogen-based combined oral contraceptives compared to ethinylestradiol-containing pills: A disproportionality analysis of the Eudravigilance database","authors":"Marie Didembourg ,&nbsp;Médéa Locquet ,&nbsp;Lucie Raskin ,&nbsp;Babel Tsague Tchimchoua ,&nbsp;Jean-Michel Dogné ,&nbsp;Charlotte Beaudart ,&nbsp;Jonathan Douxfils","doi":"10.1016/j.contraception.2024.110727","DOIUrl":"10.1016/j.contraception.2024.110727","url":null,"abstract":"<div><h3>Objectives</h3><div>Pharmacovigilance data analysis can accelerate the identification of drug-related safety signals or reassure on the safety profile. This study evaluates the venous thromboembolism (VTE) risk of newer combined oral contraceptive (COC) formulations with natural estrogens, such as estradiol (E2) and estetrol (E4), using data from the EudraVigilance database.</div></div><div><h3>Study design</h3><div>We conducted a disproportionality reporting rate analysis of VTE events associated with various COC formulations by extracting individual case reports from EudraVigilance database up to July 28, 2024. The study compared the proportionality reporting rate between natural estrogen-based COCs (E2 and E4) and conventional synthetic estrogen-based COCs (ethinylestradiol [EE]), with a comparison to EE-levonorgestrel.</div></div><div><h3>Results</h3><div>The analysis revealed that COCs containing natural estrogens exhibited significantly lower proportionality reporting rates for thrombotic events compared to EE-based COCs. Specifically, E4-drospirenone (E4-DRSP) showed the lowest proportionality reporting rate (0.12), similar to progestin-only pills. EE-DRSP had the highest proportionality reporting rate (2.25), suggesting an increased thrombotic risk.</div></div><div><h3>Conclusions</h3><div>The study supports the safer thrombotic profile of natural estrogen-based COCs, particularly E2 and E4 formulations, over synthetic estrogen-based COCs containing EE. These findings support the hypothesis that E2- and E4-based pills are safer than EE-based pills, aligning with a shift toward safer contraceptive options in clinical practice.</div></div><div><h3>Implications</h3><div>Natural estrogens such as E2 and E4 may emerge as safer alternatives to synthetic estrogens like EE, particularly when combined with progestins like DRSP. This multilevel evidence underscores the importance of evidence-based prescribing practices to enhance patient safety and minimize thrombotic risks associated with COC use.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"142 ","pages":"Article 110727"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retail availability of over-the-counter birth control pills at Texas pharmacies: Results from a mystery caller study","authors":"Brandon G. Wagner,&nbsp;Patricia Maloney,&nbsp;Ali Hooks","doi":"10.1016/j.contraception.2024.110729","DOIUrl":"10.1016/j.contraception.2024.110729","url":null,"abstract":"<div><h3>Objectives</h3><div>To estimate the availability of the recently released over-the-counter (OTC) birth control pill (Opill) in retail pharmacies and compare availability across pharmacies based on their chain status and setting.</div></div><div><h3>Study design</h3><div>In April and May 2024, we conducted a mystery caller study of a sample of 500 Texas retail pharmacies. Sampled pharmacies were contacted by female project staff posing as potential customers and asked whether they had OTC birth control pills in stock and, if not, whether they could be ordered. We characterized pharmacies by chain status (independent pharmacy, chain pharmacy inside retail outlet, chain pharmacy with standalone location) and, using geolocation, as located in either rural or urban areas.</div></div><div><h3>Results</h3><div>Overall, 62% of pharmacies (<em>N</em> = 477) reported having Opill available for sale. This stock varied by pharmacy type, with independent pharmacies the least likely to stock it (25%) and standalone chain pharmacies the most likely (82%). Similar patterns were found in terms of pharmacies that had Opill in stock or were willing to order it. We found no significant differences between urban and rural pharmacies.</div></div><div><h3>Conclusions</h3><div>Despite its recent (March 2024) launch, Opill was widely available in retail pharmacies in Texas, though independent pharmacies were less likely to stock it. While removing the need for prescriptions may make birth control pills more accessible, this access may vary by pharmacy type.</div></div><div><h3>Implications</h3><div>Following its retail launch, the first OTC birth control pill in the United States is already widely available in pharmacies in Texas. As they are highly likely to stock these OTC pills, chain pharmacies (e.g., CVS, Walgreens, Rite-Aid) may be well positioned to address existing barriers to accessing birth control pills.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"142 ","pages":"Article 110729"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Success of medication abortion with mifepristone followed by two doses of misoprostol in very early pregnancy","authors":"Lindsay Burton ,&nbsp;Rachel Perry ,&nbsp;Janet Jacobson","doi":"10.1016/j.contraception.2024.110696","DOIUrl":"10.1016/j.contraception.2024.110696","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare medication abortion (MAB) success in very early pregnancy (VEP) with mifepristone followed by either one or two doses of misoprostol.</div></div><div><h3>Study design</h3><div>We performed a retrospective cohort analysis of VEP MABs from July 1, 2021 to May 31, 2022 treated with mifepristone 200 mg oral followed by a single dose of misoprostol 800 mcg buccal 24 to 48 hours later and MABs from June 21, 2022 to October 31, 2022 treated with mifepristone 200 mg oral followed by two doses of misoprostol 800 mcg buccal spaced 4 hours apart, with first dose taken 24 to 48 hours after mifepristone. Serum BhCG was collected at the time of mifepristone treatment with additional BhCG collected 48 to 72 hours after misoprostol treatment in both groups. Success was defined as a BhCG decline of ≥50%. MAB failure was defined as ongoing, viable pregnancy determined by follow-up ultrasound or procedural intervention with aspiration.</div></div><div><h3>Results</h3><div>There were 423 patients in the single-dose misoprostol group and 262 patients in the two-dose misoprostol group. There were no significant differences between the two groups in baseline characteristics. In the single-dose group, 372 (87.9%) were treated successfully; in the two-dose group, 224 (85.5%) were treated successfully. There was no significant difference in MAB success between the groups (<em>p</em> = 0.73).</div></div><div><h3>Conclusions</h3><div>The addition of a second dose of misoprostol does not improve the success of MAB in VEP.</div></div><div><h3>Implications</h3><div>Additional research is needed to identify interventions to improve the success of MAB in VEP.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"142 ","pages":"Article 110696"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suspected hepatotoxicity from etonogestrel contraceptive implant: A rare case report","authors":"Taylore King ,&nbsp;Eric Caliendo ,&nbsp;Ericka Scott ,&nbsp;Ghiara Lugo Diaz ,&nbsp;Megan Lawley","doi":"10.1016/j.contraception.2024.110728","DOIUrl":"10.1016/j.contraception.2024.110728","url":null,"abstract":"<div><div>We present a case of suspected hepatotoxicity secondary to an etonogestrel contraceptive implant in which the patient presented with vomiting, jaundice, pruritis, elevated transaminases, and hyperbilirubinemia. An extensive work-up, including liver biopsy, was unremarkable. The implant was removed and the patient’s symptoms and transaminitis resolved, suggestive of drug-induced liver injury.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"142 ","pages":"Article 110728"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of etonogestrel bioanalytical assay results in plasma and serum within and across laboratories","authors":"Shawnalyn W. Sunagawa ,&nbsp;Lee C. Winchester ,&nbsp;Christopher S. Wichman ,&nbsp;Sean N. Avedissian ,&nbsp;David W. Erikson ,&nbsp;Molly Kernan ,&nbsp;Mark A. Marzinke ,&nbsp;Timothy M. Mykris ,&nbsp;Renu Nandakumar ,&nbsp;Thomas D. Nolin ,&nbsp;Anthony T. Podany ,&nbsp;Raymond E. West III ,&nbsp;Beatrice A. Chen ,&nbsp;Catherine A. Chappell ,&nbsp;Kimberly K. Scarsi","doi":"10.1016/j.contraception.2024.110720","DOIUrl":"10.1016/j.contraception.2024.110720","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare performance characteristics of etonogestrel bioanalytical assays across laboratories.</div></div><div><h3>Study design</h3><div>We conducted a blinded, six laboratory study: five academic laboratories and one contracted commercial laboratory (reference). Etonogestrel was quantitated at each laboratory in both prepared serum and/or plasma samples of six known etonogestrel concentrations, and in 60 clinical samples from participants using etonogestrel-containing contraceptive methods. Per regulatory guidance, laboratory accuracy (percent bias) and precision (coefficient of variation; CV) were defined as ±15% of the nominal prepared concentration. We compared inter- and intra-laboratory agreement using a Kendall’s Tau-B and Passing-Bablok regression.</div></div><div><h3>Results</h3><div>For prepared samples, six laboratories analyzed serum and three laboratories analyzed plasma. All etonogestrel results were within ±15% for accuracy across all concentrations at four labs, including the reference laboratory. All labs demonstrated high precision, with only one occurrence of CV &gt;15%. We found a positive association between prepared plasma and serum etonogestrel results (Kendall’s Tau-B 0.80–0.88). For clinical samples, five laboratories analyzed serum and three laboratories analyzed plasma. Compared to the reference laboratory, inter-laboratory serum etonogestrel concentrations were positively correlated (Kendall’s Tau-B 0.76–0.95). Proportional bias was observed, meaning individual lab etonogestrel results were consistently higher (slope estimates 0.78–0.95) or lower (slope estimates 1.05–1.10) than the reference laboratory. In clinical samples, intra-laboratory results were well associated between plasma and serum (Kendall’s Tau-B 0.92–0.96).</div></div><div><h3>Conclusions</h3><div>There was good intra-laboratory agreement, irrespective of sample matrix; however, there was inter-laboratory variability in etonogestrel results. Differences between laboratory results should be considered when comparing etonogestrel pharmacokinetics across studies.</div></div><div><h3>Implications</h3><div>Etonogestrel concentrations were highly precise within each laboratory and were comparable between serum and plasma. Results varied between laboratories (5–28% higher to 5–9% lower compared to the Organon commercial laboratory). To minimize variability, we recommend utilizing a single laboratory that conducts routine proficiency testing for etonogestrel analysis within a study.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"142 ","pages":"Article 110720"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pandemic changes in U.S. contraceptive use: National survey estimates reveal significant differences by demographic subgroups","authors":"William G. Axinn ,&nbsp;Brady T. West ,&nbsp;Heather M. Schroeder ,&nbsp;Laura D. Lindberg","doi":"10.1016/j.contraception.2024.110723","DOIUrl":"10.1016/j.contraception.2024.110723","url":null,"abstract":"<div><h3>Objectives</h3><div>The COVID-19 pandemic brought multiple simultaneous consequences, with high potential to change fertility-related behaviors. We use nationally representative sex and contraceptive use event history calendar measures to demonstrate person-specific changes in contraceptive use after the pandemic, showing differences across demographic subgroups.</div></div><div><h3>Study design</h3><div>We use data from the first nationally representative web survey of U.S. fertility, fielded in 2020–2022: the American Family Health Study (AFHS). Using responses from 1357 female-identifying respondents ages 18–49, we analyze 26,274 person-months of sex and contraceptive use data spanning directly before and after the beginning of the pandemic to detect change.</div></div><div><h3>Results</h3><div>Individual-level hazard models of starting and stopping contraception revealed no pandemic-related changes in starting contraception, but significant reductions in the rate of stopping contraception for specific subgroups. Hispanic females reduced their rates of stopping contraceptive use during the pandemic (lowering their odds of stopping use by 71%), ultimately behaving more similarly to individuals from other racial or ethnic subgroups. Additionally, those aged 41 and older significantly reduced their rates of stopping contraceptive use (lowering their odds of stopping use by 78%) relative to other age groups.</div></div><div><h3>Conclusions</h3><div>Sudden large-scale health policy changes can produce significant changes in contraceptive use behaviors. The COVID-19 changes interacted with race, ethnicity, and age to produce different changes in contraceptive behaviors among different subgroups of the U.S. population.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"142 ","pages":"Article 110723"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}