Achebe, F. (2017). Effect of Artemether Lumefantrine on Women's Reproductive Cycle: Results. Afrischolar Discovery. https://doi.org/10.60787/njgp.v15i2.121
Achebe F. Effect of Artemether Lumefantrine on Women's Reproductive Cycle: Results. Afrischolar Discovery. 2017. doi:10.60787/njgp.v15i2.121
Achebe, Francis. "Effect of Artemether Lumefantrine on Women's Reproductive Cycle: Results." Afrischolar Discovery, 2017.
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Artemether + lumefantrine was followed by ovulation defects in 3 women
Among 3 Nigerian women in a case series, all three had partial follicle rupture in the cycle when they took the malaria drug artemether + lumefantrine. Their charts also showed less cervical mucus and a weaker luteal phase.
Key Findings
Three women, aged 23, 23 and 38, were studied from May to December 2014. Each had a cycle without and a cycle with artemether + lumefantrine (artemisinin-based combination therapy, ACT).
Partial rupture syndrome, where a mature follicle ruptures only in part, occurred in all three women in the ACT cycle. Ultrasound follicular rupture difference was lower then (P = 0.002589).
Cervical mucus fell significantly in the ACT cycle (P = 0.019), about 40% on the paper's mucus score.
Luteal phase progesterone was lower in the ACT cycle than in the no-ACT cycle (P = 0.01484), and luteal phase estrogen was higher (P = 0.013015).
In the 38-year-old woman, luteal phase defects persisted in the first cycle after ACT (P = 0.034042) and the second (P = 0.00421).
Interpretation
This case series followed three Nigerian women through one cycle without artemether + lumefantrine and one cycle with it. The drug was given on days 10 to 12, once a follicle was already growing and malaria was confirmed. The authors note that follow-up ended before the luteal defects fully recovered. The findings support larger studies of this drug's effect on the reproductive cycle.
RRM Context
NaProTECHNOLOGY pairs Creighton Model FertilityCare System charting with cycle-timed ultrasound and hormone testing. The paper uses that pairing to see one medication's footprint on ovulation, mucus and the luteal phase. Charting-informed evaluation asks what changed in the ovulatory cycle. A workup without cycle charts has no such record to read.
Our editorial summary of this paper, not the article's abstract.
Abstract
Background
Malaria is prevalent in Nigeria, and artemether + lumefantrine (artemisinin-based combination therapy [ACT]) is drug of choice in treatment of uncomplicated cases. ACT is contraindicated in early pregnancy. They release-free radicals that can compromise female fertility. Infertility and its associated complications such as miscarriages, abnormal gestation, and unstable marriages seem to be on the increase. This study aims at evaluating the effect of ACT on female fertility. The significance of this research is to draw the attention of fertility care givers to this possible cause of infertility and fertility challenges.
Subjects and Methods
Creighton Model FertilityCare System and NaProTECHNOLOGY are simply technologies that can be used to assess female fertility. They are used in this study to assess the effect of ACT administered at different stages of menstrual cycles of three selected fertile adult females. The results are interpreted on the background of standard Creighton model chart.
Results
This study has shown that ACT has a significant fertility deteriorating effect on the women. It caused ovulation defect and diagnosed as partial rupture syndrome in the very cycle of use and in the first cycle after use. It also significantly reduced cervical mucus production and significantly reduced luteal phase progesterone production with an associated significant increase of luteal phase estrogen production.
Conclusion
ACT use as antimalarial may be a possible cause of infertility and fertility challenges in women.
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