Endometrial expression of glycodelin in women with levonorgestrel-releasing subdermal implants

Erik Mandelin, Hannu Koistinen, Riitta Koistinen, Johanna Arola, Biran Affandi, Markku Seppälä

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11 Citations (Scopus)


Objective: To determine whether subdermal levonorgestrel implants induce endometrial expression of glycodelin.Design: Cross-sectional, blinded study. Setting: University clinic. Patient(s): One hundred and eight women with subdermal implants and 19 postmenopausal women.Intervention(s): Endometrial biopsies, curettages, and hysterectomies. Main Outcome Measure(s): Endometrial glycodelin expression was examined through immunohistochemistry, in situ hybridization, and morphologic endometrial dating. Result(s): Overall, 80% of the endometrial specimens obtained from women with subdermal levonorgestrel implants stained positive for glycodelin. Endometrial morphology of these women showed proliferative (71%), inactive/weakly proliferative (19%), menstrual or regenerating (6.5%), and other patterns (2.8%). Of these, 79%, 71%, 100%, and 100% were glycodelin positive, respectively. Nineteen specimens were obtained during the midcycle when glycodelin is not normally expressed: of these, 89% stained positive for glycodelin. Implant-related amenorrhea was associated with endometrial glycodelin expression in 58% of the women, whereas the endometrium specimens obtained from women with postmenopausal hypoestrogenic amenorrhea contained no detectable glycodelin. Conclusion(s): Subdermal levonorgestrel implant use is often associated with endometrial expression of glycodelin. Because glycodelin has been shown to inhibit sperm-egg binding, the induction of glycodelin may contribute to the contraceptive activity of the implant.

Original languageEnglish
Pages (from-to)474-478
Number of pages5
JournalFertility and Sterility
Issue number3
Publication statusPublished - 2001


  • Contraception
  • Endometrium
  • Glycodelin
  • Subdermal levonorgestrel implant


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