North American Registry of Midwives (NARM) Practice Exam

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What is the action of progestin in Depo Provera injections?

Stimulating ovulation
Suppressing LH surge and changing endometrial receptivity
Enhancing cervical mucus for sperm entry
Increasing ovulatory cycles

The correct answer is: Suppressing LH surge and changing endometrial receptivity

The action of progestin in Depo Provera injections primarily involves suppressing the luteinizing hormone (LH) surge and altering the endometrial receptivity. Progestin, a synthetic form of progesterone, helps prevent ovulation by inhibiting the release of LH, which is crucial for the ovulatory process. Without this surge, ovulation does not occur, effectively preventing the ovaries from releasing an egg. Additionally, progestin leads to changes in the endometrium, making it less receptive to a fertilized egg. This means that even if fertilization were to occur, the altered endometrial lining would inhibit implantation. This mechanism is essential for the effectiveness of Depo Provera as a long-acting contraceptive method, as it leverages hormonal regulation to prevent pregnancy. The changes in cervical mucus, while also influenced by progestin, play a secondary role compared to its primary actions of ovulation suppression and endometrial modification.