Cervical cytological studies in women inserted with Norplant-I contraceptive.

The study was carried out by the Human Reproduction Research Centre of the Indian Council of Medical Research at Lucknow and Kanpur, India as part of a multicenter study to ascertain the oncogenic potential of Norplant-I, a progestational contraceptive, by periodic cytological evaluation of cervical smears. In total, 278 fertile healthy women were inserted with Norplant-I at the Contraceptive Clinic of the Department of Obstetrics and Gynaecology of K.G.'s Medical College, Lucknow and G.S.V.M. Medical College, Kanpur, were and followed for periods ranging from 1-5 yr. It was reassuring to note that squamous intraepithelial lesion (SIL) incidence was found to be significantly higher only in the initial stages of contraception after 1 yr of Norplant insertion, after which it declined; no SIL was seen after 3 yr of contraception. The retrogression of SIL was also seen in all 11 pre- and 15 of 18 postinsertional cases. As SIL incidence showed a rise with increasing age and parity, the study also highlighted the need for constraint in offering Norplants to women of high age and parity. The percentage of inflammatory smears were also high till 4 yr of Norplant use, warranting a need for adequate treatment and early repeat cytology to exclude the persistence of inflammation. The accumulated data indicate the safety of long-term use of Norplants upto 5 yr, as far as oncogenic potential is concerned.