Aki Kido MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: Oral contraceptives and intrauterine devices (IUD) are effective methods of contraception. Oral contraceptives suppress secretion of FSH and LH, and IUDs may prevent nidation or sperm transport, though the precise role of an IUD is still unclear. This study aimed to evaluate the effects of these contraceptives on the MR appearance of the uterus at mid-cycle and on rhythmic myometrial contractility, so-called uterine peristalsis, as displayed on cine MR imaging and postulated to play an important role in sperm transport and nidation. Methods and Materials: The subjects were 11 healthy female volunteers taking oral contraceptives (n=6), using IUDs (n=4), or both (n=1). Controls were 10 women not taking contraceptives (age range: 22-41 years). MR studies were performed at periovulatory phase on a 1.5 T magnet (Symphony, Siemens Medical Systems) using a phased-array coil. T2-weighted images were obtained conventional technique using fast spin echo. Then sequential T2-weighted images were obtained using HASTE (half-Fourier single shot turbo spin echo) to be displayed in cine mode. For three minutes, 60 serial images were obtained every three seconds by HASTE in the contraception group and every two seconds in the control group. Cine mode was evaluated at x12 faster than real speed. Two radiologists evaluated by consensus for: 1) thickness of the junctional zone (JZ) on static T2-weighted images, 2) uterine peristalsis; defined as wave-like conduction of subendometrial low intensity areas or endometrial striping on cine mode display, and 3) the direction and frequency of any perceptible peristaltic wave. Results: The JZ was identified in 20 of the subjects, but not in one taking oral contraceptives. JZ thickness was thinner in pill-users and thicker in IUD-bearing uterus compared with controls (statistical significance, P<0.008). All controls showed uterine peristalsis of cervicofundal direction with a frequency of 2.52/min. In the oral contraceptive group (n=6), peristalsis was absent in three and decreased in frequency in three (0.55/min), but all directions were cervicofundal. Peristalsis was perceptible in all IUD-using subjects, but with significantly decreased frequency compared with controls (0.98/min). However, direction was fundocervical in 4 of the 5 women. Conclusion: The results show that these contraceptive methods suppress or change the direction of the peristaltic wave, possibly disturbing the upward transport of sperm. A thicker JZ seems relevant to fundocervical peristalsis.       Questions about this event email: akikido@kuhp.kyoto-u.ac.jp

Kido MD, A, Contraceptives and Uterine Peristalsis: Evaluation with MRI.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3101330.html