Effect of depot-medroxyprogesterone acetate injections on serum immunoglobulins and complements level

Abstract

Background: Depot medroxyprogesterone acetate (Depo-Provera) is a highly effective, nondaily hormonal contraceptive option that has been available in the worldwide for 40 years and provides a very high level of contraceptive efficacy. Benefits and risks of hormonal therapy are often under scrutiny, however, long-term clinical experience has established the safety of this long-acting contraceptive in that it does not increase the risk of cardiovascular events, breast cancer , other gynecologic malignancy, or postmenopausal fracture. Aim: To evaluate the effect of depot medroxyprogesterone acetate injections on the serum immunoglobulin (IgG, IgM, IgA), and complements (C3,C4).Study design: Prospective cohort study. Study period: 1st January 2006 to 31st March 2007.Subjects & Methods: Thirty healthy married women, their age ranged between 20-35 years, who were attending Al-Batool and Al-Khansa Family Planning Centers in Mosul/ Iraq and started (for the first time) to use depot medroxyprogesterone acetate (DMPA) injection. Each injection contains 150 mg medroxyprogesterone acetate. These women called DMPA users group, were compared to another thirty healthy married women who did not use any hormonal contraceptives and were drawn from the same population and matched for age, height and weight with the DMPA users group, and they were considered to be the non users group. Both groups were followed for one year, during which blood samples were obtained from both groups, before starting to use DMPA, after 6 months and then after 12 months. The sera obtained from the blood samples were used for the estimation of the biochemical studied parameters using commercial kits. Results: Serum IgG was significantly elevated after 12 months (p = 0.028) among DMPA users in comparison to non users but non significant increase according to the duration of use. While there was a non significant changes in the serum IgM, IgA, C3 and C4 level after 6 and 12 months in the DMPA users in comparison with non users and in relation to the duration of use. DMPA caused a non significant changes in the total serum protein and serum albumin levels. Conclusion: The significant raise of serum levels of IgG may be indicative of improved humeral immunity in DMPA Iraqi users, a change that is potentially beneficial.