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Serum FSH glycoforms with increased sialylation and decreased oligosaccharide complexity reflect the decline of the gonadal activity induced either by age or by the use of a DMPA as a contraceptive.

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According to the World Health Organization (WHO), 214 million women in developing countries and low-resource settings want to avoid pregnancy, but do not use a modern contraceptive method. 1 It has been reported 2 that more than 65% of people with unplanned pregnancies in low-and middle-income countries were using traditional contraceptive methods, condoms, or combined oral contraceptives. 2 These methods have low contraceptive efficacy compared to long-acting contraceptive (LARC) methods. 3 The 52 mg levonorgestrel intrauterine system (LNG-IUS) is a highly effective LARC method. 4 However, despite the high contraceptive efficacy, few side effects, rapid return of fertility after removal, high continuation rates, and non-contraceptive benefits, 5,6 its prevalence is still low in many settings. A probable explanation may be the lack of availability in the public sector in many settings,