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Investigating contraceptives’ post-fertilization mechanism of action on the endometrium

Philip Darney, MD, MS, University of California, San Francisco, 2015

Project abstract

Surveys show that women want highly effective, on-demand, pre and post coital contraception. A promising approach to meeting this need is to block adhesion and implantation of the blastocyst to the endometrium. Development of on-demand contraceptives, as well as longer-term methods, requires a full understanding of the mechanisms of action at the endometrium. The cell adhesion molecule L-selectin, and its carbohydrate ligands, mediate the initial step of implantation in humans. Human blastocysts express L-selectin. During the luteal phase of the menstrual cycle, the endometrium up-regulates the selectin ligands. The purpose of this study is to evaluate whether oral contraceptives, levonorgestrel intrauterine devices and copper intrauterine devices block the up-regulated expression of the L-selectin ligand. Further understanding mechanisms of action of available contraceptives on the endometrium may allow future development of new on-demand contraceptives that act on the endometrium by blocking implantation leading to a highly effective pre or post coital method.

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