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Nafarelin therapy apparently has long-term effects on bone mineral density in women being treated for endometriosis. The family of drugs to which nafarelin belongs is known to adversely affect bone mineralization. Women with endometriosis were assigned to use a nasal spray for six months. The spray contained nafarelin either for the full six months or for the first three months. Bone mineral density of the thigh bone and lower spine was measured by an X-ray technique at the beginning of the experiment (baseline) and six, 12, and 18 months later. Bone mineral density declined in both groups and had not returned to baseline by the 18-month measurement. Six months' usage of nafarelin had a greater effect than three months', but by the 18-month measurement, recovery was equivalent. Calcium intake correlated positively with the degree of recovery.

The incidence of untoward events in 144 women who underwent insertion of the Copper-7 (Cu-7) intrauterine device at the time of vacuum aspiration for therapeutic abortion did not differ significantly from that in 63 women who returned 33±1.2 days following abortion for insertion of the device. Cramps and bleeding were no more severe following immediate postabortion insertion of the Cu-7 than following abortion only. During the 1-year follow-up period, the groups did not differ significantly in the total termination rate for medical reasons, although at 1 month postinsertion more women in the delayed-insertion group had the device removed because of pain and bleeding. There was a trend toward an increased incidence of expulsion in the immediate-insertion group. Two involuntary pregnancies occurred in the immediate-insertion group; no pregnancies were reported in the delayed-insertion group. During their one year of evaluation, 31.9% of the immediate-insertion group and 42.9% of the delayed-insertion group were lost to follow-up. The advantages of immediate postabortion insertion include the necessity for a single clinic visit for both extraction and insertion, and thus a single episode of discomfort; immediate contraceptive protection; and acceptance by a larger number of women.

Six hundred and eight women were treated with 200 μg of ethinylestradiol and 2mg of dl-norgestrel, administered in two divided doses, as a postcoital contraceptive. Criteria for entry into the study included definite unprotected coital exposure within the previous 72 hours and the absence of any contraindications to the use of estrogen/progestin-containing compounds. Women with coital exposures outside of the 72-hours-to-treatment time frame were excluded.

Six hundred ninety-two women were enrolled in a multicenter clinical trial to evaluate a combination of ethinyl estradiol and dl-norgestrel as a postcoital contraceptive.

The authors studied 740 consecutive in vitro fertilization (IVF) cycles over a 3-year period to compare the results of cycles in which an endogenous luteinizing hormone (LH) surge occurred with cycles in which human chorionic gonadotropin (hCG) was administered for induction of follicular maturation. Clomiphene citrate (100 to 150mg daily on cycle days 5 to 9) and human menopausal gonadotropin (hMG; 75 to 150IU daily from cycle day 6) were used for stimulation. Embryo transfer (ET) occurred in 164 (81.2%) of the LH surge cycles and 452 (84%; P=not significant [NS]) of the hCG cycles. The first urinary rise in LH was detected in the 6 or 9 A.M. collections in 78 (47.3%) of the LH surge cycles, a greater number (P<0.01) than expected if LH surge onset was random. A total of 107 pregnancies was achieved, for an overall pregnancy rate of 17.4% per ET. The pregnancy rate in the hCG-stimulated cycles was 13.9% per ET (63/452) and, in spontaneous LH surge cycles, was 28.8% (44/166; P<0.001). The spontaneous abortion rate was 9.1% in LH surge cycles, compared with 25.4% in hCG-triggered cycles (P<0.001). The result was a 2.4 times increase in live births for LH surge cycles compared with cycles in which hCG was administered. In this program, occurrence of an LH surge is a favorable event, associated with higher pregnancy and live birth rates than hCG-stimulated cycles, and usually occurring in the early morning, allowing oocyte retrieval during normal working hours.