Efficacy of two insertions of 100-minute releasing quinacrine hydrochloride pellets for non-surgical female sterilization

Abstract

Extensive research has been undertaken to develop a simple method of non-surgica/ female sterilization. Zipper and associates identified quinacrine hydrochloride as a drug likely to produce tubal occlusion when placed into the uterus. Zipper's early work with a solution of quinaerine led to the development of quinacrine pellets, a delivery system that was designed to bring the quinacrine into prolonged contact with the tubal ostia through extended uterine retention.Three transcervica/ uterine insertions of 10-minute releasing quinacrine hydrochloride pellets performed at monthly intervals have produced a 12-month pregnancy rate of 3.3 per 100 women. The ultimate goal is to develop an effective, single insertion procedure, but the perfol~mance of the quinacrine pellets in occluding tubes has necessitated more than one insertion. FHI developed a 100-minute extended release pellet system with the expectation that more prolonged drug exposure would produce a higher rate of tuba/ closure. A study of the 100-minute releasing pellet system has been conducted in Santiago, Chile. Two monthly insertions in 112 women has resulted in a 12-month pregnancy rate of 2.0 per 100 women. Postproeedure problems occurring within the first year were reported by 13% of the women; most were minor and transitory./~dvances in Con~ion.

100 000 quinacrine sterilizations

“…Other reports of two or three insertions have given similar results [4,[16][17][18][19][20][21]. Hieu and his co-workers [4] noted great variation in efficacy among inserting clinicians and hypothesized that this was due to different insertion techniques.…”

Comparison of the efficacy of intrauterine diclofenac and ibuprofen pellets as adjuvants to quinacrine nonsurgical female sterilization

“…Eligible women were asked to come to the clinic in the proliferative phase of their cycle where a physical and pelvic examination was performed. Systematically, every other subject was administered transcervically, as described by Zipper [1], six pellets of quinacrine (216 mg) and three pellets of diclofenac (75 mg) or three pellets of ibuprofen (55.5 mg). The insertions were repeated a month later.…”

“…The quinacrine pellet method of nonsurgical female sterilization as developed by Zipper and his colleagues [1] involves transcervical administration of 252 mg quinacrine hydrochloride as seven pellets through a modified Copper T intrauterine device (IUD) inserter. Two doses a month apart are given to nonpregnant women during the proliferative phase of the menstrual cycle (days 5 to 12).…”

Association for Voluntary Surgical Contraception: A technical statement on quinacrine pellets for nonsurgical female sterilization

“…In the late 1970s and early 1980s, Zipper et al [5], in Chile, with the help of Family Health International (FHI), began performing phase I clinical trials in women using, first, a 10-minute release formulation of quinacrine pellets requiring three separate insertions, and then a 100-minute release formulation requiring two insertions. The investigators reported a 12-month failure rate of 3.3 and 2.0 respectively, with follow-up of 80% of the study cases.…”