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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 instillation 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 instillation 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 exitation, and one case of acute adnexitis. The second instillation was not performed for 16.0% and the third instillation 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.

A study was undertaken to look at the clinical behavior of the Dalkon Shield, the Lippes Loop D and the TCu-200 inserted by physicians and midwives. Differences among the three devices were not statistically significant, although lower expulsion rates and higher pregnancy rates were reported for the Dalkon Shield. No differences were observed between insertions performed by physicians and those performed by midwives; this emphasizes the efficiency of using paramedical personnel in the field of intrauterine contraception.

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