A Randomized Trial on the Impact of Starting Day on
Ovarian Follicular Activity in Very Low Dose Oral Con
traceptive Pills Users
SOMKIAT SITAVARIN,MD*,
UNNOP JAISAMRARN, MD, MUS*,
SURASAK TANEEPANICHSKUL, MD, MPH*
Affiliation : *Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
AbstractIn a randomized trial, the impact of starting day (the first and the seventh day of the period)
on ovarian follicular activity was assessed during administration of a very low dose of oral contracep
tive pills (20 microgram (meg) ethinyl estradiol (EE) and 75 meg gestodene (GS) [Meliane, Schering,
Germany]). One hundred and sixty healthy women aged: 23-44 years, who had a regular cycle, and who
were not using any type of oral contraceptive (OCs) steroid were studied at the Family Planning Clinic
of King Chulalongkorn Memorial Hospital, Bangkok, Thailand. In the trial, each subject received a
package of Meliane. They were block wise randomized, 1 : 1 ratio; in the first group, subjects began their
= =
pills on the first day of their period (n 80) and the other group, the seventh day of their period (n
80). During the treatment cycle, ovarian activity was evaluated by transvaginal sonography (TVS) to
determine the follicular-like structure (FLS). Ovulation was defined as the dominant FLS detected by
TVS and followed-up every other day until its collapse. It occurred in 0 of 77 cases who started on the
first day of their period and occurred in 8 of 78 cases of the group which started on the seventh day
=
of their period. The difference was of statistical significance (p 0.006). The result of this clinical trial
is beneficial information for users of OCs containing 20 meg EE who delay start of the OCs package.
Keywords : Oral Contraceptive, Follicular Liked Structure, Ovulation
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