Abortifacient Effects of Chemical, Hormonal, and IUD Birth Control Products According to FDA Labeling in the Physicians’ Desk Reference Compiled by Ryan C. MacPherson, PhD on 7/3/2008 from: Physicians’ Desk Reference, 62d ed. (Montvale, NJ: Thompson Healthcare, 2007), a standard compilation of the FDA-required labels for over 4,000 approved drugs.

Updated by Erich Heidenreich, DDS on 3/21/2012

Combination Oral Contraception (COC) Pills [a.k.a. “Oral Contraception Pills” (OCP), all commonly referred to as “The Pill”] “Combination oral contraceptives act by suppression of gonadotropins. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increase the difficulty of sperm entering into the uterus) and the endometrium (which reduce the likelihood of implantation)” (repeated at pp. 777 [Yasmin], 785 [Yaz], 1046 [Mircette], 1057 [Seasonique], 2402 [Ortho Cyclen and Ortho Tri-Cyclen], 2411 [Ortho Tri-Cyclen Lo], and 3367 [Lybrel]). Brand Name (Manufacturer)

Progestational Component

Estrogenic Component

Ortho Cyclen (Ortho)

0.250 mg norgestimate

0.035 mg ethinyl estradiol

Ortho Tri-Cyclen (Ortho)

0.18 mg norgestimate

0.035 mg ethinyl estradiol

Ortho Tri-Cyclen Lo (Ortho)

0.180 mg norgestimate

0.025 mg ethinyl estradiol

Lybrel (Wyeth)

90 mcg levonorgestrel

20 mcg ethinyl estradiol

Mircette (Duramed)

0.15 mg desogestrel x 20 None x 5

0.02 mg ethinyl estradiol x 20 0.01 mg ethinyl estradiol x 5

Seasonique (Duramed)

0.15 mg levonorgestrel

0.03 mg ethinyl estradiol

Yaz (Bayer)

3 mg drospirenone

0.020 mg ethinyl estradiol

Yazmin (Bayer)

3 mg drospirenone x 21 None x 7

0.030 mg ethinyl estradiol x 21 None x 7

Combination Patch “Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increase the difficulty of sperm entering into the uterus) and the endometrium (which reduce the likelihood of implantation)” (p. 2390). Brand Name (Manufacturer) Ortho Evra (Ortho)

Progestational Component 6.00 mg norelgestromin

Estrogenic Component 0.75 mg ethinyl estradiol

Progestin-Only Pills (POP) (also known as the “mini-pill”) “Ortho Micronor® progestin-only contraception prevents conception by suppressing ovulation in approximately half of users, thickening the cervical mucus to inhibit sperm penetration, lowering the midcycle LH and FSH peaks, slowing the movement of the ovum through the fallopian tube, and altering the endometrium” (p. 2399). The “failure rate” (i.e., on-pill sustained pregnancy rate) is 0.5% in perfect use vs. “close to 5%” in typical use (p. 2399). Of these pregnancies, “up to 10%” are ectopic (p. 2400). Brand Name (Manufacturer) Ortho Micronor (Ortho)

Progestational Component 0.35 mg norethidrone

Estrogenic Component None

Emergency Contraception Pills (ECP) “Plan B is believed to act as an emergency contraceptive principally by preventing ovulation or fertilization (by altering tubal transport of sperm and/or ova). In addition, it may inhibit implantation (by altering the endometrium). It is not effective once the process of implantation has begun” (p. 1056). “When taken immediately before ovulation is to occur, Ella postpones follicular rupture. The likely primary mechanism of action of ulipristal acetate for emergency contraception is therefore inhibition or delay of ovulation; however, alterations to the endometrium that may affect implantation may also contribute to efficacy.” (08/2010 FDA approved labeling) Brand Name (Manufacturer)

Progestational Component

Progesterone agonist/antagonist

Plan B One Step (Duramed) Next Choice

0.75 mg levonorgestrel 0.75 mg levonorgestrel

None None

Ella (Watson Pharma)

None

30 mg ulipristal acetate

Note: Ella, Plan B One-Step, Next Choice and generic Levonorgestrel Tablets are the only dedicated product specifically marketed for emergency contraception. However, Aviane, Cryselle, Enpresse, Jolessa, Lessina, Levora, Lo/Ovral, LoSeasonique, Low-Ogestrel, Lutera, Lybrel, Nordette, Ogestrel, Portia, Quasense, Seasonale, Seasonique, Sronyx and Trivora have been declared safe and effective for use as ECPs by the United States Food and Drug Administration. Plan B One-Step and Next Choice are available over-the counter to women and men aged 17 and older. You can buy these pills by prescription if you are younger. Ella is available by prescription only. Note: Important information on the deadly effects of “Ella” on the placenta of a developing fetus: http://www.frcblog.com/tag/donna-harrison/ Donna Harrison, MD, is a member of Emmaus Lutheran Church (LCMS) in South Bend, Indiana. She is an OB-GYN and the current president of the American Association of Pro-life Obstetricians. Read her scientific remarks at the FDA hearing on Ella here: http://www.frcblog.com/2010/06/3487/

Progestin-Only Injections “Depo Provera … inhibits the secretion of gonadotropins, which prevents follicular maturation and ovulation and causes endometrial thinning. These actions produce its contraceptive effect” (p. 2612). Brand Name (Manufacturer) Depo Provera (Pharmacia; Upjohn)

Progestational Component 104 mg/0.65mL medroxyprogesterone acetate (MPA)

Intrauterine Devices (IUD) “The contraceptive effectiveness of ParaGard is enhanced by copper continuously released into the uterine cavity. Possible mechanism(s) by which copper enhances contraceptive efficacy include interference with sperm transport or fertilization, and prevention of implantation” (p. 1052). “The local mechanism by which continuously released levonorgestrel enhances contraceptive effectiveness has not been conclusively demonstrated. Studies of MIRENA prototypes have suggested several mechanisms that prevent pregnancy [i.e., prevent “clinical pregnancy,” which is not said to be established until implantation in the uterus]: thickening of cervical mucus preventing passage of sperm into the uterus, inhibition of sperm capacitation or survival, and alteration of the endometrium. … MIRENA has mainly local progestogenic effects in the uterine cavity. Morphological changes of the endometrium are observed, including stromal pseudodecidualization [endometrial thinning], glandular atrophy, a leucocytic infiltration and a decrease in glandular and stromal mitosis” (p. 765). Brand Name (Manufacturer) ParaGard Copper T380A IUD Mirena IUD (Bayer)

Description 176 mg copper wire coiled around a polyethylene T-frame, 32 mm wide, 36mm tall, 3 mm in diameter levonorgestrel (progestational component), released at 20 mcg/day from a polyethylene T-frame, 32 mm x 32 mm