In Vitro Release of Levonorgestrel from a new form of Levonorgestrel Releasing Intrauterine Devices "Metraplant-E"

Abstract

Progesterone is a key hormone in regulating the female reproductive system, interacting at the level of the hypothalamus, the ovary, the uterus and the breast. Progesterone exerts effects on ovulation, endometrial differentiation, cervical mucus, breast differentiation and uterine contractility. Progestins are available in a variety of formulations. Intrauterine delivery of progestin is an effective way to administer local treatment and bypass systemic side effects. Intrauterine drug delivery has the potential to treat many gynecologic conditions. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a safe, effective and acceptable form of contraception used worldwide. It also has a variety of noncontraceptive benefits including treatment for menorrhagia, endometriosis, and endometrial hyperplasia. The LNG-IUS has also been used in combination with estrogen for hormone replacement therapy and as an alternative to hysterectomy. Overall, the system is very well tolerated and patient satisfaction is quite high when proper education regarding possible side effects is provided. However, despite all of the obvious benefits of the LNG-IUS, utilization rates remain quite low in the developed countries, especially in the United States, because clinicians lack knowledge and skills and because the only current delivery system (Mirena®; Bayer HealthCare) is unavailable or costly in many countries. Metraplant-E, which is used in this study, is a modified levonorgesrel-releasing intrauterine system from the old IUD “Metraplant”, modified by Azzam 2013, Metraplant-E design has a T-shaped frame containing Levonorgestrel and Ethylene Vinyl Acetate (EVA) as well as Barium Sulphate to make it radio-opaque, All the "T"