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Levonorgestrel-releasing intrauterine device-wearing women express contraceptive glycodelin A in endometrium during midcycle: another contraceptive mechanism?



Levonorgestrel-releasing intrauterine device-wearing women express contraceptive glycodelin A in endometrium during midcycle: another contraceptive mechanism?



Human Reproduction 12(12): 2671-2675



Glycodelin A (GdA), a uterine glycoprotein that exerts local contraceptive activity by inhibiting sperm-egg binding, is generally absent from the endometrium during the fertile midcycle and is not expressed until postovulatory day 5. In this study of endometrial specimens collected from 6 Finnish users of the levonorgestrel-releasing IUD, "inappropriate" expression of GdA between days 7 and 16 of the cycle was observed in every case. Endometrium samples showed epithelial atrophy and stromal decidualization regardless of the duration of IUD use. GdA was localized to endometrial glands, with only sporadic faint patches in the stroma. Unexpected expression of GdA was also detected in 4 of 11 endometria from women with copper-releasing IUDs. Based on the potent inhibitory activity of GdA on sperm-egg binding, the presence of GdA in the uterine glands of hormone-releasing IUD users may lead to prior exposure of sperm to contraceptive GdA, thus contributing to the fertility control activity of the device.

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Accession: 046543149

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PMID: 9455833


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