The Experts below are selected from a list of 139758 Experts worldwide ranked by ideXlab platform
Catherine Hart - One of the best experts on this subject based on the ideXlab platform.
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long acting reversible contraceptive acceptability and unintended pregnancy among women presenting for short acting methods a randomized patient preference trial
American Journal of Obstetrics and Gynecology, 2017Co-Authors: David Hubacher, Hannah Spector, Charles Monteith, Pailien Chen, Catherine HartAbstract:Background Measures of contraceptive effectiveness combine technology and user-related factors. Observational studies show higher effectiveness of long-acting reversible Contraception compared with short-acting reversible Contraception. Women who choose long-acting reversible Contraception may differ in key ways from women who choose short-acting reversible Contraception, and it may be these differences that are responsible for the high effectiveness of long-acting reversible Contraception. Wider use of long-acting reversible Contraception is recommended, but scientific evidence of acceptability and successful use is lacking in a population that typically opts for short-acting methods. Objective The objective of the study was to reduce bias in measuring contraceptive effectiveness and better isolate the independent role that long-acting reversible Contraception has in preventing unintended pregnancy relative to short-acting reversible Contraception. Study Design We conducted a partially randomized patient preference trial and recruited women aged 18–29 years who were seeking a short-acting method (pills or injectable). Participants who agreed to randomization were assigned to 1 of 2 categories: long-acting reversible Contraception or short-acting reversible Contraception. Women who declined randomization but agreed to follow-up in the observational cohort chose their preferred method. Under randomization, participants chose a specific method in the category and received it for free, whereas participants in the preference cohort paid for the Contraception in their usual fashion. Participants were followed up prospectively to measure primary outcomes of method continuation and unintended pregnancy at 12 months. Kaplan-Meier techniques were used to estimate method continuation probabilities. Intent-to-treat principles were applied after method initiation for comparing incidence of unintended pregnancy. We also measured acceptability in terms of level of happiness with the products. Results Of the 916 participants, 43% chose randomization and 57% chose the preference option. Complete loss to follow-up at 12 months was P P = .01 when comparing randomized groups). In the secondary comparisons involving only short-acting reversible Contraception users, the continuation probability was higher in the preference group compared with the randomized group ( P = .04). However, the short-acting reversible Contraception randomized group and short-acting reversible Contraception preference group had statistically equivalent rates of unintended pregnancy ( P = .77). Seventy-eight percent of randomized long-acting reversible Contraception users were happy/neutral with their initial method, compared with 89% of randomized short-acting reversible Contraception users ( P 90%). Conclusion Even in a typical population of women who presented to initiate or continue short-acting reversible Contraception, long-acting reversible Contraception proved highly acceptable. One year after initiation, women randomized to long-acting reversible Contraception had high continuation rates and consequently experienced superior protection from unintended pregnancy compared with women using short-acting reversible Contraception; these findings are attributable to the initial technology and not underlying factors that often bias observational estimates of effectiveness. The similarly patterned experiences of the 2 short-acting reversible Contraception cohorts provide a bridge of generalizability between the randomized group and usual-care preference group. Benefits of increased voluntary uptake of long-acting reversible Contraception may extend to wider populations than previously thought.
Jeffrey F Peipert - One of the best experts on this subject based on the ideXlab platform.
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injectable Contraception issues and opportunities
Contraception, 2014Co-Authors: Andrew M Kaunitz, Jeffrey F Peipert, David A GrimesAbstract:Beginning in the 1960s depot medroxyprogesterone acetate (DMPA) injectable Contraception has been widely used in family planning programs abroad especially in Africa and Southeast Asia [1]. Approved in the US for the treatment of endometrial cancer in the mid-1960s it was also used off-label for Contraception [2]. In 1992 DMPA received Food and Drug Administration (FDA) approval for Contraception and began to have a noticeable impact in preventing unintended pregnancies in the US particularly among teens. By 2002 some 2 million US women used injectable Contraception [3]. Whereas US teen births increased 23% from 1986 peaking in 1991 rates then declined 35% by 2005 [4]. The authors of the 2002 National Survey of Family Growth (NSFG) reported that “Teens were more likely in 2002 to use Contraception at first sex and at most recent sex than in 1995 and were more likely to have used highly effective methods such as injectable Contraception” [5]. Copyright © 2014 Elsevier Inc. All rights reserved.
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the contraceptive choice project reducing barriers to long acting reversible Contraception
American Journal of Obstetrics and Gynecology, 2010Co-Authors: Gina M Secura, Jenifer E Allsworth, Tessa Madden, Jennifer L Mullersman, Jeffrey F PeipertAbstract:Objective To introduce and promote the use of long-acting reversible methods of Contraception (LARC; intrauterine contraceptives and subdermal implant) by removing financial and knowledge barriers. Study Design The Contraceptive CHOICE Project is a prospective cohort study of 10,000 women 14-45 years who want to avoid pregnancy for at least 1 year and are initiating a new form of reversible Contraception. Women screened for this study are read a script regarding long-acting reversible methods of Contraception to increase awareness of these options. Participants choose their contraceptive method that is provided at no cost. We report the contraceptive choice and baseline characteristics of the first 2500 women enrolled August 2007 through December 2008. Results Sixty-seven percent of women enrolled (95% confidence interval, 65.3–69.0) chose long-acting methods. Fifty-six percent selected intrauterine Contraception and 11% selected the subdermal implant. Conclusion Once financial barriers were removed and long-acting reversible methods of Contraception were introduced to all potential participants as a first-line contraceptive option, two-thirds chose long-acting reversible methods of Contraception.
Dominique De Ziegler - One of the best experts on this subject based on the ideXlab platform.
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serum antimullerian hormone levels remain stable throughout the menstrual cycle and after oral or vaginal administration of synthetic sex steroids
Fertility and Sterility, 2008Co-Authors: Isabelle Streuli, Timothee Fraisse, Christine Pillet, Victoria Ibecheole, P Bischof, Dominique De ZieglerAbstract:OBJECTIVE: To investigate whether oral or vaginal administration of contraceptive hormones might affect antimullerian hormone (AMH) levels. DESIGN: Prospective trial with women recruited by advertisement. Women who wished Contraception were randomized between oral or vaginal estroprogestative Contraception, and those who did not choose Contraception were included in the control group. SETTING: Fertility clinic of a tertiary university hospital. PATIENT(S): Twenty-four young, healthy volunteer women with regular cycles who had received no hormonal Contraception for at least 3 months before the study. INTERVENTION(S): Oral or vaginal estroprogestative Contraception from day 5 to 25 of a menstrual cycle versus no Contraception. MAIN OUTCOME MEASURE(S): Intercycle and intracycle variations of serum AMH levels in normally ovulating volunteers and following the initiation of oral or vaginal estroprogestative Contraception. RESULT(S): Fluctuations of AMH levels observed during the menstrual cycle remained within cycle-to-cycle variability in cycling controls and in women receiving oral or vaginal Contraception. CONCLUSION(S): Our findings confirm that AMH levels remain steady during the menstrual cycle and indicate that they are unaffected by exogenous sex steroids used for Contraception whether administered orally or vaginally.
David Hubacher - One of the best experts on this subject based on the ideXlab platform.
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long acting reversible contraceptive acceptability and unintended pregnancy among women presenting for short acting methods a randomized patient preference trial
American Journal of Obstetrics and Gynecology, 2017Co-Authors: David Hubacher, Hannah Spector, Charles Monteith, Pailien Chen, Catherine HartAbstract:Background Measures of contraceptive effectiveness combine technology and user-related factors. Observational studies show higher effectiveness of long-acting reversible Contraception compared with short-acting reversible Contraception. Women who choose long-acting reversible Contraception may differ in key ways from women who choose short-acting reversible Contraception, and it may be these differences that are responsible for the high effectiveness of long-acting reversible Contraception. Wider use of long-acting reversible Contraception is recommended, but scientific evidence of acceptability and successful use is lacking in a population that typically opts for short-acting methods. Objective The objective of the study was to reduce bias in measuring contraceptive effectiveness and better isolate the independent role that long-acting reversible Contraception has in preventing unintended pregnancy relative to short-acting reversible Contraception. Study Design We conducted a partially randomized patient preference trial and recruited women aged 18–29 years who were seeking a short-acting method (pills or injectable). Participants who agreed to randomization were assigned to 1 of 2 categories: long-acting reversible Contraception or short-acting reversible Contraception. Women who declined randomization but agreed to follow-up in the observational cohort chose their preferred method. Under randomization, participants chose a specific method in the category and received it for free, whereas participants in the preference cohort paid for the Contraception in their usual fashion. Participants were followed up prospectively to measure primary outcomes of method continuation and unintended pregnancy at 12 months. Kaplan-Meier techniques were used to estimate method continuation probabilities. Intent-to-treat principles were applied after method initiation for comparing incidence of unintended pregnancy. We also measured acceptability in terms of level of happiness with the products. Results Of the 916 participants, 43% chose randomization and 57% chose the preference option. Complete loss to follow-up at 12 months was P P = .01 when comparing randomized groups). In the secondary comparisons involving only short-acting reversible Contraception users, the continuation probability was higher in the preference group compared with the randomized group ( P = .04). However, the short-acting reversible Contraception randomized group and short-acting reversible Contraception preference group had statistically equivalent rates of unintended pregnancy ( P = .77). Seventy-eight percent of randomized long-acting reversible Contraception users were happy/neutral with their initial method, compared with 89% of randomized short-acting reversible Contraception users ( P 90%). Conclusion Even in a typical population of women who presented to initiate or continue short-acting reversible Contraception, long-acting reversible Contraception proved highly acceptable. One year after initiation, women randomized to long-acting reversible Contraception had high continuation rates and consequently experienced superior protection from unintended pregnancy compared with women using short-acting reversible Contraception; these findings are attributable to the initial technology and not underlying factors that often bias observational estimates of effectiveness. The similarly patterned experiences of the 2 short-acting reversible Contraception cohorts provide a bridge of generalizability between the randomized group and usual-care preference group. Benefits of increased voluntary uptake of long-acting reversible Contraception may extend to wider populations than previously thought.
Isabelle Streuli - One of the best experts on this subject based on the ideXlab platform.
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serum antimullerian hormone levels remain stable throughout the menstrual cycle and after oral or vaginal administration of synthetic sex steroids
Fertility and Sterility, 2008Co-Authors: Isabelle Streuli, Timothee Fraisse, Christine Pillet, Victoria Ibecheole, P Bischof, Dominique De ZieglerAbstract:OBJECTIVE: To investigate whether oral or vaginal administration of contraceptive hormones might affect antimullerian hormone (AMH) levels. DESIGN: Prospective trial with women recruited by advertisement. Women who wished Contraception were randomized between oral or vaginal estroprogestative Contraception, and those who did not choose Contraception were included in the control group. SETTING: Fertility clinic of a tertiary university hospital. PATIENT(S): Twenty-four young, healthy volunteer women with regular cycles who had received no hormonal Contraception for at least 3 months before the study. INTERVENTION(S): Oral or vaginal estroprogestative Contraception from day 5 to 25 of a menstrual cycle versus no Contraception. MAIN OUTCOME MEASURE(S): Intercycle and intracycle variations of serum AMH levels in normally ovulating volunteers and following the initiation of oral or vaginal estroprogestative Contraception. RESULT(S): Fluctuations of AMH levels observed during the menstrual cycle remained within cycle-to-cycle variability in cycling controls and in women receiving oral or vaginal Contraception. CONCLUSION(S): Our findings confirm that AMH levels remain steady during the menstrual cycle and indicate that they are unaffected by exogenous sex steroids used for Contraception whether administered orally or vaginally.