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PREHYSTERECTOMY STUDIES(continued) Clinicopathologic study of Fallopian tube closure after single transcervical insertion of quinacrine pellets. R. H. Merchant (Obstetrics and Gynecology, B.Y.L. Nair Hospital, Bombay, India); S. R. Prabhu (Department of Pathology, T.N. Medical College, Bombay, India); E. Kessel (Department of Public Health and Preventive Medicine, Oregon Health Sciences University, Portland, Oregon). International Journal of Fertility 1995; 40:47-54. *NOTE: If you are unfamiliar working with PDF files Summary: To determine the effect on tubal closure of intrauterine quinacrine by dose and time from administration, a study was designed. Subjects included 33 women of reproductive age who were awaiting hysterectomy for nonmalignant conditions at a Bombay, India medical college. Ten women received 252 mg quinacrine as pellets using a modified Copper-T IUD inserter followed by hysterectomy within 6 weeks, and 23 women received 324 mg quinacrine followed by hysterectomy 6 to 20 weeks post-insertion. Hysterosalpingograms were done before insertion, prior to surgery and on the fresh surgical specimen. The uteri and tubes were subjected to histology studies, including grading of tubal damage. For study of dose, an additional 7 women receiving 100 mg quinacrine (and previously reported) were included. Tubal closure rates were measured by hysterosalpingogram and tubal histology. It was concluded that tubal closures were directly related to quinacrine dose and length of insertion-hysterectomy interval. For the 252 mg quinacrine dose, 55.0% of intramural tubal segments and 5.9% of isthmic segments showed histologic evidence of closure. For the 324 mg dose, all intramural tubal segments and 58.8% of isthmic segments showed histologic evidence of closure. Clinical conditions, such as dysfunctional uterine bleeding, were associated with lower tubal closure rates. Multivariate discriminate analysis showed quinacrine dose to be more important than quinacrine-hysterectomy interval.*** Transcervical applications of pellets of quinacrine were administered to volunteers among women requiring hysterectomy for nonmalignant conditions. Both the dose of quinacrine and the quinacrine to hysterectomy interval were varied. The effect of the dose of quinacrine and quinacrine to hysterectomy interval on tubal closure was determined by hysterosalpingogram and on degree of inflammatory reaction in the intramural portion of Fallopian tubes upon histologic examination. Both higher dose and longer insertion to hysterectomy intervals were associated with success. This suggests some failures may be due to inadequate time for inflammation and fibrosis to occur. Dysfunctional uterine bleeding reduced the success rate. Age and parity had no significant effect on success. It is recommended that in a future trial of the quinacrine pellet method, an additional contraceptive be used for at least six weeks from the last insertion of quinacrine pellets.Histologic changes in the fallopian tubes after lower dose of transcervical quinacrine insertion. AR Sarin, A Mohindroo, P Chandra, SS Gill.. Fertility and Sterility 1998; 70:Suppl. 1 (abstract p-121)S164. *NOTE: If you are unfamiliar working with PDF files Summary: Conclusions: 1) A single transcervical 180 mg insertion of Q causes total occlusion of all fallopian tubes after 36 days. 2) In contrast to our earlier study with 252 mg Q. the changes are less marked in the isthmus & fimbrial end which may be an advantage should the need for recanalization arise. 3) A lower single transcervical insertion of 180 mg may be safer than the presently recommended two insertions of 252 mg Q for sterilization.THE QUINACRINE SLURRY METHOD Chemically induced tubal occlusion in the human female using intrauterine instillation of quinacrine. A. Benoit, J. Melancon, M-A. Gagnon (INRS-SANTE, Montreal-Gamelin, Quebec, Canada). Contraception 1975; 12:95-101. *NOTE: If you are unfamiliar working with PDF files Summary: Thirty healthy volunteers, 30 years and older, received one or more intrauterine instillations of quinacrine (1 gm) in order to obtain a chemically induced occlusion of the Fallopian tubes. Prior patency of the latter was checked either by the Rubin test or by hysterosalpingography (in 8 patients). Bilateral occlusion occurred in 12 patients after the first instillation; this was shown by Rubin's test, done for all subjects 4 to 6 weeks after the procedure, and by hysterosalpingography in 11 out of the 12 patients with a negative Rubin test. From the remaining 17 volunteers (one opted out), 11 cases of occlusion were obtained after a second instillation. Three patients received a third instillation, with positive results in two. Thus bilateral occlusion was produced in 25 of the 30 referred patients. So far 11 patients were seen in follow-up 6 to 8 months after the last instillation; in all cases hysterosalpingography confirmed the long lasting state of occlusion.Chemically induced tubal occlusion in the human female following a single instillation of quinacrine. O.W. Davidson, C. Wilkins (University of Miami Medical School, Miami, Florida). Contraception 1973; 7:333-9. *NOTE: If you are unfamiliar working with PDF files Summary: In a case study of 10 fertile women receiving a single intrauterine instillation of a suspension of quinacrine, the 6 patients who did not have a hysterectomy 5 to 6 days later were found to have non-patent tubes when tested at least 3 weeks post-instillation. Five of these patients were using oral contraception prior to, during, and after treatment. Of the remaining 4 patients who underwent surgery within one week of instillation, three were found to have lesions suggesting tubal inflammation; none of these patients were using any kind of contraception.Quinacrine-induced tubal occlusion. O.W. Davidson (School of Medicine, University of Miami, Miami, Florida). In: Advances in Female Sterilization: Sciarra JJ, Droegemueller W, Speidel JJ, eds.. New York: Harper and Row 1976; pp. 200-7. *NOTE: If you are unfamiliar working with PDF files Summary: From the collected data in this area, it is clear that the problem with quinacrine lies more in an appropriate delivery system that would assure contact between quinacrine and the tubal epithelium than in the potentiation of the drug by means of other chemicals. In this sense, the author and his colleagues believe that steroid contraception prior to and postinstillation may play a role by 1) diminishing the thickness of the endometrium and allowing quinacrine to reach the ostium and 2) by interfering with the normal replacement of the tubal epithelium. Furthermore, pre- and postinstillation contraception is useful in avoiding instillations in patients who are in the early stages of pregnancy, as well as pregnancies that may occur before tubal occlusion.Clinical evaluation of quinacrine hydrochloride for sterilization of the human female. C. Israngkun, S. Phaosavadi (Chulalongkorn University, Bangkok, Thailand); R.S. Neuwirth (St. Luke's Hospital Center, New York); R.M. Richart (Columbia University, New York). Contraception 1976; 14:75-80. *NOTE: If you are unfamiliar working with PDF files Summary: Sixty women seeking sterilization were treated with 1 gm of quinacrine in 7 ml of sterile water applied via a Kahn cannula with an olive tip held against the cervix. The tubal closure rate by hysterosalpingogram and/or pregnancy was 44%. In view of the need for multiple applications of this drug and some of the potential problems of the method as yet not clarified, widespread clinical trials are not warranted. However, further testing may resolve the current limitations and risks of the method to yield a useful clinical technique.Chemical sterilization with quinacrine. S. Mehtaji (Grant Medical College and Cama and Albless Hospital, Bombay, India); K. Jadwani, V. Goyal (Institute of Research and Reproduction, Bombay, India).. In: Fourth transaction of scientific papers at the India FRP Contributors' Conference held at the West End Hotel, Bombay, February 24, 1977 Pachauri S, ed., Calcutta, India Fertility Research Programme September 1977; p 167-70. *NOTE: If you are unfamiliar working with PDF files Summary: Quinacrine sterilization is a simple method; the drug is inexpensive, the equipment is simple and the method can be used on an out-patient basis. No anesthesia is necessary and hospitalization is not required. There is no need for specialized personnel or sophisticated equipment. If this method proves to be effective it could be popular. Even though the success rate is not as high as with surgical procedures this method of tubal occlusion deserves large-scale trials with careful follow-up.Human fertility control by transvaginal application of quinacrine on the Fallopian tube. J.A. Zipper, E. Stachetti, M. Medel (Hospital Barros Luco-Trudeau and Instituto de Fisiologia, Universidad de Chile, Santiago, Chile). Fertility and Sterility 1970; 21:581-9. *NOTE: If you are unfamiliar working with PDF files Summary: This paper presents the results of additional and more detailed clinical studies of the intrauterine instillations of solutions of quinacrine to control fertility. Group A. Tubal obstruction was produced in 60 of the 85 patients (70.5%). In 68 patients tubal insufflation was performed after each instillation in consecutive cycles in order to determine tubal patency. Tubal obstruction was found after the first cycle following the initial instillation in 24 of the 68 studied patients (35.2%). It can be seen that the cumulative tubal occlusion rate was 88.2% after three consecutive instillations. The rate of pregnancies/100 woman-years in relation to the number of instillations which produced tubal obstruction dropped from 4.9 after one instillation to 1.2 after three instillations.Chemical agents for transvaginal sterilization. J. Zipper, M. Medel, E. Stachetti, L. Pastene, M. Rivera, R. Prager.. In: Human Sterilization. Proceedings of the conference, Cherry Hill, New Jersey, October 28-31, 1969: Richart RM, Prager DJ, eds., Springfield, Illinois: Charles C. Thomas 1972; p 339-352. *NOTE: If you are unfamiliar working with PDF files Summary: Experimental and clinical experiences of the authors suggest the possibility of developing simple methods to occlude the human oviduct at the level of the ostium. The anatomic and physiological properties of this area permit action at this site, which is essential for the transport of sperm and blastocysts. The endometrial mucosa is not affected to a substantial degree because of its thickness and its capacity for periodic recovery; endometrial recovery is dependent upon glandular mechanisms which are not affected by cytotoxics. Since the ostial region of the tubal mucosa is thin, it is easy to produce changes in it by the injection of cytotoxics if they make contact in adequate concentrations. The possibility of developing a nonsurgical sterilizing technique using a chemical agent of low toxicity that requires no sophisticated application apparatus, that can be employed by paramedical personnel, and requires only two applications, opens unexpected perspectives in human fertility control.Transvaginal chemical sterilization: clinical use of quinacrine plus potentiating adjuvants. J. Zipper, E. Stacchetti, M. Medel (University of Chile, Santiago, Chile). Contraception 1975; 12:11-21. *NOTE: If you are unfamiliar working with PDF files Summary: Six years of experience with the use of transvaginal quinacrine as an obliterating agent of the intramural portion of the Fallopian tube are presented. Fifteen different forms of treatment using various dosages of quinacrine, alone as well as in combination with several other pharmacologic agents were studied. The purpose of these studies was to increase the rate of tubal obstruction, with 1 or 2 instillations of solution. The total experience is based on 638 patients who received treatment according to a prefixed plan. There was a total of 14,677 woman months of observation and a group of 437 patients were diagnosed as having tubal obstruction with CO2 insufflation. Out of this group, 50 pregnancies were observed, none of them ectopic, for a Pearl Index of 4.10. The most effective treatment regimen, quinacrine + xylocaine, with and without epinephrine, after the second instillation had an obstruction rate of 94%. Most of the pregnancies in obstructed patients occurred in the first year and appeared to be due to incomplete obstruction of the oviduct.The clinical efficacy of the repeated transcervical instillation of quinacrine for female sterilization. J. Zipper, M. Medel (School of Medicine, University of Chile, Santiago; Sotero del Rio Hospital, Puente Alto); A. Goldsmith, D. Edelman (International Fertility Research Program, Research Triangle Park, North Carolina); L. Pastene, M. Rivera (School of Medicine, University of Chile, Santiago; Sotero del Rio Hospital, Puente Alto). International Journal of Gynaecology and Obstetrics 1976; 14:499-502. *NOTE: If you are unfamiliar working with PDF files Summary: The safety and efficacy of the repeated transcervical instillation of quinacrine hydrochloride in a suspension of 5 ml of 2% Xylocaine was evaluated in 200 patients. All these procedures were performed during the proliferative phase of the menstrual cycle: the second instillation was made in the first menstrual cycle following the initial instillation and the third and last, at 6 months after the first. None of the patients used any adjunctive contraceptives. Follow-up visits were scheduled at 6-month intervals after the last instillation. The potentially serious complications following the instillation were four cases of cortical excitation and one case of acute adnexitis. The second instillation was not performed for 16.0% and the third was not performed for 16.7% of the patients, for medical and/or personal reasons. Fifty-one pregnancies were reported, 41 (80.4%) before completion of the three instillations. The results of this study show that the instillation schedule used is unsatisfactory for widespread use. Additional studies are currently being conducted to evaluate the use of an adjunctive contraceptive up to the time of the third instillation in order to reduce the high pregnancy rate.THE PAP (PHENOL-ATABRINE [QUINACRINE]-BILIGRAPHINE PASTE) METHOD Effectiveness of phenol-atabrine-paste (PAP) instillation for female sterilization. X.P. Kang (School of Public Health, Beijing Medical University, China); H.Z. Wan (Renming Hospital, Beijing); P. Wang (The First Affiliated Hospital, Beijing); S.X. Wang (School of Public Health, Beijing Medical University); L.P. Chow (School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, Maryland). International Journal of Gynecology and Obstetrics 1990; 33:49-57. *NOTE: If you are unfamiliar working with PDF files Summary: Two groups of sterilized women, 3307 by phenol-Atabrine paste (PAP) instillation and 1026 by mini-lap technique, were follow-up interviewed to determine their relative effectiveness. PAP, if successfully performed, was as effective as the mini-lap. The life table pregnancy rates among successful PAP women were 0.21 and 0.28 at 12 and 24 months, respectively. The rates among the unsuccessful PAP women, however, were high: 15.1 and 30.5 at 12 and 24 months, respectively. Despite its distinctive advantage of being nonsurgical, wider promotion of PAP sterilization procedure deserves caution.Nonsurgical procedures for manual instillation of a phenol-Atabrine paste (PAP) for female tubal occlusion. Y.H. Wu (Xin Hua Hospital, Shanghai Second Medical College, China); P.L. Qian (Institute of Pharmaceutical Industry of Shanghai); S.P. Tien (Xin Hua Hospital, Shanghai Second Medical College).. In: Female Transcervical Sterilization: Zatuchni GI, Shelton JD, Goldsmith A, Sciarra JJ, eds., Philadelphia: Harper and Row 1983; p 151. *NOTE: If you are unfamiliar working with PDF files Summary: A nonsurgical method by manual instillation of a phenol-Atabrine paste (PAP) into the tubes for occlusion has been evaluated. In a period of 3 years and 9 months in 1972-1976, 1837 procedures were carried out by the Shanghai Non-Surgical Cooperative, composed of five medical units, and the procedures were successful in 1708 cases, giving a rate of 92.98%. In a follow-up study of 1637 immediately successful cases in the 4 to 7-year period, the success rate was 99.08% (in terms of occluded tubes). The total number of procedures done to date in all of Shanghai between 1972 and 1981 is 9500, with a successful occlusion rate of 99%. Among the 200 medical units offering this procedure, a study of 33 such units, located in 5 provinces, indicates that between 1975 and 1981, 30,000 women have had the procedure, and in those women who have had a follow-up of more than 2 years, a successful occlusion rate of 99% has been obtained. The failures resulted from improper instillation and PAP that was too thick. The ideal tubal occlusion medium will include a combination of chemicals that will cause fewer side-effects and febrile reactions but will have a high success rate. Although our sterilization procedure is not done under direct vision, the manual technique of inserting the tip of a polyethylene tube into the Fallopian tube for instillation of PAP can be learned through proper training. Our procedure is simple and without severe reaction, and it has few complications. So far there is no mortality. The success rate for female sterilization is high, and the results are promising.Discussion: Chinese techniques for chemical sterilization. G.I. Zatuchni (Program for Applied Research on Fertility Regulation, Northwestern University Medical School, Chicago, Illinois).. In: Female Transcervical Sterilization: Zatuchni GI, Shelton JD, Goldsmith A, Sciarra JJ, eds., Philadelphia: Harper and Row 1983; p 172. *NOTE: If you are unfamiliar working with PDF files Summary: During the past 5 or 6 years, individuals interested in nonsurgical methods of female sterilization have been tantalized by published reports of work by Chinese scientists in this field. Two simple and promising techniques, using different approaches and materials, have been described and Drs. Tien and Zheng supplied further details in the discussion summarized here. The following questions were raised: How many individuals are doing these procedures, and how many procedures have been done up to the present time? How long does it take to become expert in the PAP instillation technique? How long does it take to perform the PAP instillation, from the time the patient gets on the table until the procedure is completed? In the roentgenograms, some of the PAP was seen flowing back into the cornual areas; is this a usual occurrence? After the PAP injection, does the material coming back into the uterine cavity produce irritation of the endometrium, adhesions, Asherman's syndrome, or similar problems? Do patients have a significant amount of pelvic pain or other side-effects following instillation of the phenol-mucilage? Are the complaints about pain more severe with the chemical procedure than with standard surgical sterilization procedures? What percentage of patients elect surgical sterilization rather than chemical sterilization? What is considered "success" in the PAP procedure? How successful are efforts at follow-up in China?QUINACRINE PELLET METHOD CLINICAL TRIALS Clinical evaluation of quinacrine pellets for chemical female sterilization. T. Agoestina, I. Kusuma (Hasan Sadikin Hospital, Bandung, Indonesia). Advances in Contraception 1992; 8:141-51. *NOTE: If you are unfamiliar working with PDF files Summary: Under the auspices of the Coordinating Board of Indonesian Fertility Research (BKS PENFIN), a clinical trial was undertaken to examine the safety and effectiveness of the quinacrine pellet method for nonsurgical female sterilization. One hundred women were selected to receive 3 monthly insertions of 250 mg of quinacrine and were followed up at 1, 3, 6 and 12 months after the third insertion. Socioeconomic data and complaints and menstrual patterns at each insertion and every follow-up visit were recorded, as were all failures. The life-table failure rate was determined to be 3.1. The continuation rate in this study was 96% at 1 year. Just over one-fifth of the women had amenorrhea by the third insertion, but most returned to normal by 1 year, and it appears that this amenorrhea was transient in nature. The method proved to be safe and effective, suggesting that larger clinical trials are in order.Nonsurgical female sterilization with quinacrine pellets: Malaysian experience. H. Arshat, A. E. Suan, K. S. Kim (National Population and Family Development Board, Kuala Lumpur, Malaysia). Malaysian Journal of Reproductive Health 1987; 5:61-9. *NOTE: If you are unfamiliar working with PDF files Summary: Due to the small sample size of only 25 subjects it is difficult to conclude at the present moment on the effectiveness and safety of this method of sterilization. A larger study is needed to test its acceptability among Malaysian women. The method offers certain advantages over the current surgical methods in being easy to administer and deliverable in a clinic setting. We may benefit from a simplified system for delivery of the quinacrine pellets requiring no more than one procedure and an improvement in the efficacy of new formulations of the quinacrine compound. It was observed that potential subjects are reluctant to undergo this method of sterilization, probably because it is new and unfamiliar and its effectiveness is uncertain.Comparison of the efficacy of intrauterine diclofenac and ibuprofen pellets as adjuvants to quinacrine nonsurgical female sterilization. N.R. Bairagi (Indian Rural Medical Association, West Bengal, India); B.C. Mullick (Indian Rural Medical Association, Calcutta, India); E. Kessel (Oregon Health Sciences University, Portland, Oregon); S.D. Mumford (Center for Research on Population and Security, Research Triangle Park, North Carolina. Advances in Contraception 1995; 11:303-308.. *NOTE: If you are unfamiliar working with PDF files Summary: To investigate relative efficacy of intrauterine diclofenac and ibuprofen as adjuvants to intrauterine quinacrine for nonsurgical sterilization, a total of 900 women were systematically allocated to 2 monthly insertions of pellets of diclofenac (75 mg) or ibuprofen (55.5 mg) as adjuvants to intrauterine quinacrine (216 mg) in a rural private practice in West Bengal, India. All women were prescribed oral contraceptives for three months from first insertion. In the middle of the study increased care was taken to insert pellets at the fundus. There was no statistically significant difference found in cumulative life-table pregnancy failure rates at 36 months for women receiving diclofenac (2.7± 0.82) or ibuprofen 3.4 ± 0.89). Taking care to insert pellets at the fundus resulted in a decline of failures at 24 months from 4.4 ± 0.92 to zero. Intrauterine administration of pellets of quinacrine (216 mg) plus diclofenac (75 mg) or ibuprofen (55.5 mg) with 3 months oral contraception provides acceptable efficacy if pellets are inserted to the fundus.Quinacrine: nonsurgical female sterilization. A. Bashir (Mother and Child Welfare Association, Faisalabad, Pakistan). Advances in Contraception Delivery Systems 1993; 9:37-42. *NOTE: If you are unfamiliar working with PDF files Summary: Non surgical sterilization was performed on 2100 women in Faisalabad by a single insertion of 7 pellets (252 mg) of quinacrine hydrochloride through an IUCD inserter. During 1 year follow-up, only 85 pregnancies (4%) were recorded. No serious complications or side-effects were reported. Although the study is of short duration and limited follow-up, it clearly shows that quinacrine tubal occlusion is a highly acceptable (84.1%), effective (96%) and an inexpensive method of contraception that has very few side effects (6.8%) and negligible chances of ectopic pregnancy.Quinacrine non surgical female sterilization. A. Bashir, M. Mustansar (Allied Hospital, Punjab Medical College, Faisalabad, Pakistan); M. A. Cheema (Population Study Centre, University of Agriculture); S. Akram (Punjab Medical College); R. Naheed (W.M.O. Gulzar Colony MCH Centre, Faisalabad). The Gynaecologist 1993; 3:129-36. *NOTE: If you are unfamiliar working with PDF files Summary: An experience with quinacrine nonsurgical tubal occlusion in 2100 women at a sterilization center in Faisalabad over a period of 1 year (January to December, 1990) is presented. A trial of single insertion of 7 pellets (250 mg quinacrine HCL) using an IUCD inserter has been carried out; 85 pregnancies have been recorded so far. No serious complications or side effects were reported. Although the study is of short duration and of limited follow-up, the fact that it is highly acceptable, simple, safe, effective, inexpensive and can be performed by a paramedical personnel needs to be widely known and practiced in developing countries.Quinacrine Sterilisation: A Community Service. A Bashir (Mother and Child Welfare Association), Faisalabad, Pakistan . Acta Obstetricia et Gynecologica Scandinavica 1997; Vol 76: Sup. 167:4 p.16 (Abstract). *NOTE: If you are unfamiliar working with PDF files Summary: Quinacrine sterilisation (QS) was added as an option for women in 1990 as part of a broad maternal and child health programme of the Mother and Child Welfare Association (MCWA), an NGO in Faisalabad, Pakistan. An intensive family planning community education effort was made in 1990, resulting in increased contraceptive prevalence of all methods. QS, a nonsurgical method, was accepted by 2100 women in 1990, compared to 402 accepting tubectomy. QS was provided by our own 20 MCR Centres, the Municipal Corporation Family Health Centres, private medical practitioners, hospitals and traditional birth attendants. Community surveys in the area of our main MCH Centre showed an increase in contraceptive prevalence from 12.1% in 1989 to 41.7% in 1990, of which 18.1% was female sterilisation. QS made a greater contribution to contraceptive prevalence than any other method. We have now completed over 10,000 QS procedures using a single insertion of seven quinacrine pellets of 36 mg each. There have been no case fatality or life threatening complications, and efficacy compares well to other contraceptive methods.Quinacrine-non surgical tubal occlusion. R. Begum, S. N. Bhuiyan (Chittagong Medical College, Chittagong). In: Indian Progress in Family Welfare: Proceedings of IXth Indian Conference on Family Welfare & Voluntary Sterilization, Ahmedabad 13-15th November, 1992; pp. 239-42. *NOTE: If you are unfamiliar working with PDF files Summary: Quinacrine was used in a total of 177 women during a period of about three years from October 1989 to August 1992 in Chittagong Medical College Hospital. Among those attended for follow-up, two had become pregnant. The quinacrine nonsurgical female sterilization method has been described as one that is safe and effective as compared to surgery, and can be performed on an outpatient basis by paramedics after a brief course of training.Quinacrine family planning method: Letters to the Editor. M. Berer (editor, Reproductive Health Matters, London, United Kingdom):. Lancet 1994; 343:1425-7. *NOTE: If you are unfamiliar working with PDF files Summary: Takes exception to Lancet editorial on use of quinacrine for female sterilization. A critique of Hieu's study appeared in Pollack and Carignan's article in her journal of 1993, Volume 2, 119-22.Chemical female sterilization using quinacrine pellets. R. Bhatt, K. M. Jariwala (Department of Obstetrics and Gynaecology, Medical College and S. S. G. Hospital, Baroda, India); P. Bhiwandiwala, L. Laufe (International Fertility Research Program, Research Triangle Park, North Carolina). In: Proceedings of the Third International Seminar on Maternal and Perinatal Mortality. Pregnancy Termination and Sterilization, New Delhi, October 3-5, 1980: V. Hingorani, R. D. Pandit, V. L. Bhargava, eds. 1980; pp. 370-7313. *NOTE: If you are unfamiliar working with PDF files Summary: Study undertaken to evaluate efficacy of quinacrine pellets in producing tubal blockage. The pellet was found more convenient than previously used solution. Quinacrine does produce fibrosis and tubal blockage. What is the optimal dosage? Because only 80 women were included and there were 3 insertions, this is only a preliminary report.Four-year follow-up of insertion of quinacrine hydrochloride pellets as a means of nonsurgical female sterilization. R. Bhatt (Baroda Medical College and Hospital, India); C.S. Waszak (Family Health International, Research Triangle Park, North Carolina). Fertility and Sterility 1985; 44:303-6. *NOTE: If you are unfamiliar working with PDF files Summary: Eighty-four women were admitted to a study in Baroda, India, designed for evaluation of the efficacy of three transcervical insertions of quinacrine hydrochloride pellets, each 1 month apart, in producing occlusion of the oviducts. A 4-year follow-up has been completed for 100% of the women. Three of them became pregnant during the time between the first and third administrations. Of the 81 women remaining in the study after administrations were complete, 3 became pregnant during the 4-year follow-up period, which resulted in a cumulative life-table pregnancy rate of 3.7 at 48 months. The results of this study indicate that intrauterine insertion of quinacrine pellets can be a safe, effective nonsurgical sterilization procedure.QUINACRINE PELLET METHOD CLINICAL TRIALS (Continued on Next Page) |