Abstract

Ulipristal acetate (UPA) and levonorgestrel are used as emergency hormonal contraceptives. Although both are highly effective in preventing pregnancy, UPA shows efficacy even when taken up to 120 h after unprotected sexual intercourse. To investigate whether the mechanism of UPA's contraceptive action involves post-fertilization effects. In vitro and in vivo studies using cultured human endometrial cells and a pre-clinical rat model. Endometrial cells treated with UPA showed changes in the expression of receptivity gene markers and a significant decrease in trophoblast spheroids attached to the cultured cells. In addition, administration of UPA to female unmated rats decreased the expression of implantation-related genes in the endometrium and inhibited the number of implantation sites in the mated group compared to the non-treated group. These results support that UPA as an emergency contraceptive might have post-fertilization effects that may affect embryo implantation.

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