Effect of combined oral contraceptive pills on oxidative stress, immunoglobulin and complement levels

Abstract EN

Objective: The aim of this study is to evaluate the effects of hormonal oral combined contraceptive pills “Microgynon” on serum immunoglobulin’s (IgA, IgM, IgG), with complements (C3, C4), serum antioxidant markers (total antioxidant status, serum uric acid) and serum malondialdehyde which is the end product of lipid per oxidation.

Design : Cohort study design.

Setting : This study was inducted in Al-Batool Family Planning Center and Al-Kansa Family Planning Center from the 1st of Dec.

2003 to 30 Apr.

2005.

Subjects and Methods : Out of 105 females attending Al-Batool Family Planning Center and Al-Khansa Family Planning Center in Mosul, selected according to certain inclusion criteria, 90 completed the study, starting to use Microgynon tablets (for the first time), which are one of the monophasic, second generation combined oral contraceptive pills (containing 30 µg ethinyl estradiol and 150 µg levonorgestrel).

These were considered the combined oral contraceptive pills (COCPs) users group, in comparison to another 90 healthy married women who did not use any hormonal contraceptive and were drawn from the same population and matched for age, height and weight with the COCPs users group.

These were considered to be the non users group.

Both groups were followed for one year, during which fasting blood samples were obtained from COCPs users and non users groups initially, then after 6 months and 12 months.

The sera obtained from the blood samples were used to estimate the biochemical parameters under study using commercial kits except serum malondialdehyde (MDA) which was measured by manually prepared reagents.

Results : Serum IgG and C4 level were significantly elevated after 12 months of use (p = 0.018; p = 0.011) respectively, and C3 after 6 months (p = 0.006) and 12 months (p=0.003) among COCPs users.

Beside that these changes significantly increased with the duration of COCps uses, mainly after 12 months, while no significant changes occurs in IgA and IgM levels.

Total antioxidant level was significantly elevated after 6 months (p = 0.005) and 12 months (p = 0.002) among COCPs users in comparison to non users and according to the duration of use.

While MDA serum level showed a non¬significant reduction among COCPs users in comparison to non users and in relation to the duration of use, serum uric acid increased significantly after 12 months of COCPs use (p < 0.001) in comparison to non users and in relation to the duration of use.

Conclusion : COCPs caused a significant elevation in the humoral immunity especially IgG, complements C3, C4 and significant antioxidant effects (as reflected by the reduction in MDA serum level and the raise in total antioxidant status and serum uric acid).