Studies of quinacrine and of tetracycline for non-surgical female sterilization

Abstract

The transcervical quinacrine pellet method developed by Zipper and co-workers is potentially a much needed safe, inexpensive, and effective non-surgical method of female sterilization. This method utilizes an intrauterine device inserter to deposit 250 mg of quinacrine hydrochloride as pellets in the uterine cavity. No complications or side effects, other than temporary pain and oligomenorrhea, have been reported. Tetracycline has an established track record for safety. It also has been reported to have properties similar to quinacrine as a sclerosing agent, with potential as a non-surgical method using the quinacrine insertion technique. To expand the experience with quinacrine and to study tetracycline as an alternative, studies were undertaken under the auspices of the Indian Rural Medical Association in Calcutta, India. During the period 14 August, 1979 to 28 June, 1984, 414 women received three insertions of 200 mg of quinacrine. There were 29 failures and a three-year life table failure rate of 8.5. During the period 25 April, 1984 to 28 December 1984, 55 women received three insertions of 200 mg of tetracycline. By 1 June, 1986 there were 32 failures among the 55 cases for a failure rate of 58%. A more recent study using a single dose of 1000 mg of tetracycline also produced unacceptably high failure rates.

A potential single insertion protocol for quinacrine pellet non-surgical female sterilization

“…For example, in one study where tetracycline was used as the sclerosing agent rather than quinacrine, 32 of 55 women (58%) treated returned to the clinic pregnant and in another, 35 of 102 women (34%) returned to the clinic pregnant [9]. Furthermore, in one postabortion protocol using quinacrine, 15 of 50 women returned pregnant (30%) and, in another one, 12 of 50 returned pregnant (24%) [9]. (These two studies provided important evidence that blood in the uterus, for any reason, including procedure trauma, interferes with the action of the quinacrine.…”

Blockade of tubal patency following transcervical administration of polidocanol foam: initial studies in rhesus macaques

“…Quinacrine, tetracycline, doxycycline, erythromycin, chloroquine, demeclocine, primaquine, and trimethoprim have been evaluated using the rat uterine and other animal models for their potential ability to cause tubal sclerosis and occlusion [5-8]. Quinacrine is the best-characterized agent, with multiple human studies completed including large clinical trials [9-12].…”