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Wednesday, July 1, 2015

NSAIDs Dramatically Reduce Ovulation With Consistent Use

ROME — Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to inhibit ovulation and reduce progesterone levels in young women, which could seriously undermine fertility, new research suggests.

"I'm actually a very late whistleblower because many others have tried to say the same thing: that NSAIDs — which are widely used and can be bought without a prescription — prevent the ovarian follicle from rupturing so women who are taking NSAIDs cannot release an ovum to be fertilized," said Sami Salman, MD, from the University of Baghdad.

Although "this process is reversible, a woman is not going to get pregnant if she continues to take NSAIDs, and doctors need to advise women to stop taking these drugs if they want to be fertile," he told Medscape Medical News.

Dr Salman presented the study results here at the European League Against Rheumatism Congress 2015.

He and his colleagues evaluated 39 women of childbearing age who presented to a rheumatology clinic in Baghdad with minor back pain.

The women were assigned to one of four treatment regimens: diclofenac 100 mg/day, naproxen 500 mg twice daily, etoricoxib 90 mg/day, or placebo.

Before the initiation of treatment, each woman underwent an ultrasound to assess the diameter of the dominant follicle, ovary size, and endothelial thickness.

 Doctors need to advise women to stop taking these drugs if they want to be fertile.
Because progesterone, which is essential for ovulation and the implantation of a fertilized embryo, is known to be affected by NSAIDs, progesterone levels were also measured.

The treatments were initiated on day 10 of a woman's cycle to ensure a follicle was being readied for release, Dr Salman explained.

After 10 continuous days on the treatment regimen, the women underwent another ultrasound to assess the effect of the therapy.

The dominant follicle remained unruptured in 75% of women in the diclofenac group, 25% in the naproxen group, 33% in the etoricoxib group, and 0% in the placebo control group.

"All control patients on placebo ovulated, but ovulation was far less frequent in patients who were on NSAIDs," Dr Salman reported.

"For those taking diclofenac, ovulation was reduced by an amazing 93%, whereas for both naproxen and etoricoxib, ovulation was reduced by about 75%," he added. "This was really a shocking finding."

After 10 continuous days of NSAID use, there was a significant decrease in progesterone.

NSAIDs also had an effect on the dominant follicle.


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