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Sixteen women ages 20 to 41 participated in a project to evaluate the in vivo intravaginal spermicidal effectiveness of nonoxynol-9 foaming suppositories. Testing of each subject was done at 18 different time intervals ranging from 5 seconds to 6 hours following insertion of the vaginal contraceptive. Simulated coitus using a latex dildo was incorporated in the test design to simulate dispersal of the spermicide that occurs during coitus. Semen specimens meeting uniform criteria for sperm count, motility, morphology, and volume were injected intravaginally; three vaginal aspirates were then immediately obtained to evaluate sperm motility microscopically. Maximal spermicidal effectiveness was found between 5 minutes and 1 hour after insertion of the vaginal contraceptive.
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Contraception with Lippes Loop D was compared in 1 group of women (N 172) who used a spermicidal preparation with intercourse and a second group (N 190) who used no spermicidal preparation. In the group with a Lippes Loop and a spermicidal preparation, there were 1.2% unplanned pregnancies compared to 6.4% unplanned pregnancies without spermicidal preparation. This combined method approaches the reliability of oral contraception. The third group of women who used a spermicidal preparation erratically is not comparable in the statistical sense to the other two groups. However in this third group there were less unwanted pregnancies than in the group without the use of spermicidal preparation.
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A new vaginal contraceptive method that offers the ease of use with none of the potentially harmful physiologic effects of hormonal contraception was subjected to direct in vivo tests of its efficacy in immobilizing spermatozoa and preventing their entry into the cervical canal. The new contraceptive, a small avoid only 2.8 cm long and 1.4 cm wide, is easily inserted into the vagina without the need for special applicators. It offers protection through the delivery of a highly effective spermicide by the effervescent formation of foam that disperses over the uterine opening. In the trials, no motile spermatozoa could be found in any samples obtained from the vagina, the os externum, or the cervical canal immediately after intercouse protected with the new agent. In no case were any sperm, even immotile sperm, observed in the cervical canal. By contrast, examination of 30 samples obtained immediately after coitus protected with another contraceptive agent (used as a control) revealed motile spermatozao in the cervical canal in nine cases, and propulsive motility was seen on five occasions. The new contraceptive proved highly effective in preventing conception.
A new chemical contraceptive in the form of a vaginal suppository was evaluated in a series of in vitro and in vivo tests and compared to a leading contraceptive foam and cream. Good in vitro spermicidal effect was observed, but problems in solubility and the position of the suppository against the external cervical os may lead to less clinical effectiveness if not properly evaluated prior to its use.
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326 healthy couples were selected to enter the trial of a new intravaginal contraceptive called the TA-RO CAP. The trial lasted three years. Clinical and laboratory examinations were performed periodically to determine the long-term effectiveness, tolerability and acceptance. Statistical evaluation of results was performed by life-table analysis.
Vas irrigation during vasectomy, to effect immediate sterility or to shorten the interval between vasectomy and sterility, has received increasing attention in recent years. A review of the literature on vas irrigation is presented. Topics discussed include the effectiveness of various irrigants and irrigation methods, method and technical failures, and evidence of increased risks of recanalization, inflammation, tissue damage, and infection. Stored sperm and their location after vasectomy are explored. Suggested mechanisms for the action of irrigants are reviewed, and another mechanism is proposed. Variations in study results and our incomplete understanding of vas and seminal vesicle physiology during ejaculation (compounded by individual variations) require more investigation before large clinical trials are initiated.
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Investigation of the fertility-rate after discontinuation of use of oral contraceptives shows that the monthly rate consistently follows an oscillatory pattern. This pattern appears to be unique to women who have discontinued the use of oral contraceptives. It may result from synchronisation of a previously unrecognised natural cycle, rebound changes in the reproductive system following steroidal contraception, or an infertile period associated with early intrauterine mortality.
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