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Contraception Journal
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Contraception Highlights October 2015

Editorial

Tenth anniversary of the Society of Family Planning
Philip Darney, Mitchell D. Creinin, Mark Nichols, Melissa Gilliam, Carolyn L. Westhoff
This issue of the journal celebrates the 10th anniversary of the Society of Family Planning (SFP). The society has grown from 18 Founding members and 33 Charter members (all named below) at its founding in 2005 to 591 members in 2015. How did we get here?
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Commentary

The SFP research priority setting process
Susan L. Higginbotham
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Original Research Articles

A dose-finding, cross-over study to evaluate the effect of a Nestorone®/Estradiol transdermal gel delivery on ovulation suppression in normal ovulating women
Vivian Brache, Ruth Merkatz, Narender Kumar, Cristian Jesam, Heather Sussman, Elena Hoskin, Kevin Roberts, Mohcine Alami, Deshawn Taylor, Aidelis Jorge, Horacio Croxatto, Ellen Lorange, Daniel R. Mishell, Regine Sitruk-Ware
Objective: This study aims to determine the lowest effective of three Nestorone (NES)/estradiol (E2) transdermal gel doses to ensure ovulation suppression in 90–95% of cycles.
Conclusion: While all three doses blocked ovulation effectively and were evaluated as safe and acceptable, the medium dose was considered the lowest effective dose based on a more adequate suppression of follicular development. Further development of this novel contraceptive delivering NES and E2 is warranted and has potential for improved safety compared to ethinyl-estradiol-based methods.
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Serum adipocytokines and adipose weight gain: a pilot study in adolescent females initiating depot medroxyprogesterone acetate
Andrea E. Bonny, Hannah L.H. Lange, Erinn M. Hade, Bram Kaufman, Michael D. Reed, Sam Mesiano
Objective: To evaluate whether serum adipocytokine concentrations, controlling for baseline adiposity, are predictive of adipose weight gain in adolescents initiating depot medroxyprogesterone acetate (DMPA).
Conclusions: Serum adiponectin concentration may be useful for assessing risk of DMPA-associated adipose gains.
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Levonorgestrel-releasing intrauterine system versus a low-dose combined oral contraceptive for treatment of adenomyotic uteri: a randomized clinical trial
Omar M. Shaaban, Mohammed K. Ali, Ali Mohamed A. Sabra, Diaa Eldeen M. Abd El Aal
Introduction: This study compares the efficacy of a levonorgestrel-releasing intrauterine system (LNG-IUS) and a low-dose combined oral contraceptive (COC) in reducing adenomyosis-related pain and bleeding.
Conclusion: Both LNG-IUS and COCs decreased the pain and menstrual bleeding that is associated with adenomyosis. However, LNG-IUS is more effective than the COCs in reducing pain and menstrual blood loss. This effect may be secondary to the decrease in uterine volume and the increase in blood flow resistance.
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Contraception post severe maternal morbidity: a retrospective audit
E. Jane MacDonald, Beverley Lawton, Stacie E. Geller
Introduction: Rapid repeat pregnancy is associated with maternal and neonatal morbidity. Effective postpartum contraception should be offered to all women, including those who experience severe acute maternal morbidity (SAMM), but little is known about contraceptive initiation in this group. Severe preexisting comorbidities with high pregnancy-related mortality risks are an important subset. This study examines contraceptive advice and prescription for SAMM cases with or without severe preexisting comorbidity.
Discussion: These results indicate substandard contraceptive care for women experiencing SAMM. All those with severe preexisting comorbidities left hospital postpartum without receiving contraception. Improvement in immediate postpartum contraceptive care for these women is advocated to avoid future morbidity and mortality.
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Risk-based screening for Chlamydia trachomatis and Neisseria gonorrhoeae prior to intrauterine device insertion
Jaclyn M. Grentzer, Jeffrey F. Peipert, Qiuhong Zhao, Colleen McNicholas, Gina M. Secura, Tessa Madden
Objective: The objective was to compare three strategies for Chlamydia trachomatis and Neisseria gonorrhoeae screening prior to intrauterine device (IUD) insertion.
Implications: Using a risk-based screening strategy (age≤25, multiple sexual partners, inconsistent condom use and/or history of an STI) to determine who should be screened for C. trachomatis and N. gonorrhoeae prior to IUD insertion will miss very few cases of infection and obviates the need for universal screening.
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Intrauterine device use in an urban university clinic: safety of use in a population at high risk for sexually transmitted infections
Robin W. Drake, Summer L. Martins, Amy K. Whitaker
Objective: The objective was to describe infection rates after intrauterine device (IUD) placement at an urban teaching hospital that did not restrict IUD eligibility based on risk factors for sexually transmitted infections (STIs).
Conclusion: Postplacement infection in this unrestricted population was infrequent and comparable to reported rates in previous studies.
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Motivational interviewing to improve postabortion contraceptive uptake by young women: development and feasibility of a counseling intervention
A.K. Whitaker, M.T. Quinn, S.L. Martins, A.N. Tomlinson, E.J. Woodhams, M. Gilliam
Objective: The objective was to develop and test a postabortal contraception counseling intervention using motivational interviewing (MI) and to determine the feasibility, impact and patient acceptability of the intervention when integrated into an urban academic abortion clinic.
Implications: The use of motivational interviewing in contraception counseling may be an appropriate and effective strategy for increasing use of contraception after abortion. This study demonstrates that this patient-centered, directive and collaborative approach can be developed into a counseling intervention that can be integrated into an abortion clinic.
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Introducing medication abortion into public sector facilities in KwaZulu-Natal, South Africa: an operations research study
Kelly Blanchard, Naomi Lince-Deroche, Tamara Fetters, Jaymala Devjee, Ilundi Durão de Menezes, Karen Trueman, May Sudhinaraset, Errol Nkonko, Jack Moodley
Objectives: Examine the feasibility of introducing mifepristone–misoprostol medication abortion into existing public sector surgical abortion services in KwaZulu-Natal, South Africa.
Implications: Mifepristone–misoprostol medication abortion was successfully integrated into public sector surgical abortion services in South Africa and was chosen by a large majority of women who were eligible and offered choice of early termination method; access to medication abortion should be expanded in South Africa and other similar settings.
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The costs of accessing abortion in South Africa: women’s costs associated with second-trimester abortion services in Western Cape Province
Naomi Lince-Deroche, Deborah Constant, Jane Harries, Kelly Blanchard, Edina Sinanovic, Daniel Grossman
Objectives: To assess women’s costs of accessing second-trimester labor induction and dilation and evacuation (D&E) services at four public hospitals in Western Cape Province, South Africa.
Implications: Limited access to second-trimester, safe abortion services in South Africa may result in some women incurring unnecessary costs. Women make multiple visits in attempting to obtain an abortion, often because of facility or health systems requirements, and incur costs for lost income, child care, transport, fees and supplies.
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Evaluation of service quality in family planning clinics in Lusaka, Zambia
Nancy L. Hancock, Bellington Vwalika, Elizabeth Siyama Sitali, Clara Mbwili-Muleya, Benjamin H. Chi, Gretchen S. Stuart
Objective: To determine the quality of contraceptive services in family planning clinics in Lusaka, Zambia, using a standardized approach.
Implications: Although clients perceived the quality of care received to be high, family planning service quality could be improved to continuously offer the full spectrum of contraceptive options. The Quick Investigation of Quality was easily implemented in Lusaka, Zambia, and this simple approach could be utilized in a variety of settings as a modality for quality improvement.
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In vivo release of levonorgestrel from Sino-implant (II) — an innovative comparison of explant data
Rebecca L. Callahan, Douglas Taylor, David W. Jenkins, Derek H. Owen, Linan Cheng, Aida M. Cancel, Laneta J. Dorflinger, Markus J. Steiner
Objectives: Measuring the amount of progestin remaining in contraceptive implants used for different lengths of time provides useful information on in vivo release kinetics including change over time. We compared estimated in vivo levonorgestrel (LNG) release rates derived from Sino-implant (II) explants with similar data from removed Jadelle.
Implications: This innovative approach provides evidence that Sino-implant (II) may perform clinically similarly to Jadelle over 3 years and remain a highly effective contraceptive beyond this time point. Data from explant analyses show promise for investigating the equivalence of elusion profiles of contraceptive implants.
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Conference Abstracts

North American Forum on Family Planning
On November 14–16, 2015, the Society of Family Planning, Planned Parenthood Federation of America and the Association of Reproductive Health Professionals will come together to host the fifth annual North American Forum on Family Planning (the Forum) in Chicago. The Forum is an opportunity for investigators in the area of contraception and abortion to present results of emerging studies that help us think about and provide family planning and abortion care in more innovative ways. A total of 244 scientific abstracts were submitted and reviewed by a peer panel. The Forum's Scientific Committee accepted 125 abstracts for poster presentation at the meeting and 55 abstracts for online presentation. The committee selected 21 of the top-ranked abstracts for oral presentation and chose to highlight four outstanding abstracts in a plenary session.
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