1.  Title: Female contraception over 40. Author: The ESHRE Capri Workshop Group Source: Human Reproduction Update. 2009 May 20; Abstract: BACKGROUND The majority of women 40-49 years of age need an effective method of contraception because the decline in fertility with age is an insufficient protection against unwanted pregnancy. Although pregnancy is less likely after the age of 40 years, the clinical and social consequences of an unexpected pregnancy are potentially detrimental. No contraceptive method is contraindicated by advanced reproductive age alone; thus there is a need to discuss the effectiveness, risks and non-contraceptive benefits of all family planning methods for women in this age group. METHODS MEDLINE searches were done by topic (epidemiology, age and reproduction, sexual function, delayed childbearing and specific contraceptive methods). The topic summaries were presented to the Workshop Group and omissions or disagreements were resolved by discussion. RESULTS The decline in fecundity in the fifth decade is insufficient for contraceptive purposes. Thus a family planning method is needed. Sterilization is by far the most common method in several countries. Copper intrauterine devices and hormone intrauterine systems have similar effectiveness, with fewer than 1% failures in the first year of typical use. Special considerations in this age group include the frequency of menstrual irregularity, sexual problems and the possibility of menopausal symptoms, all of which may respond to hormonal methods of contraception. CONCLUSIONS Women should be advised to continue with a contraceptive method until they have reached the menopause with its natural state of sterility. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | MENOPAUSE | FAMILY PLANNING | FEMALE STERILIZATION | BIOLOGICAL AGING | AGE FACTORS | Developed Countries | North America | Americas | Demographic Factors | Population | Reproduction | Sterilization, Sexual | Physiology | Biology | Population Characteristics Document Number: 341250 |
| 2. Title: Determination of conversion coefficient to evaluate couple-year of protection (CYP) for tubectomy and vasectomy in urban and rural regions of Iran: IMES Study. Author: Alinejad F; Heidarzade A; Eslami M; Faraji R; Shatti M Source: Journal of Reproduction and Contraception. 2009 Jun;20(2):81-92. Abstract: Objective: To calculate couple-year of protection (CYP) by conversion coefficient (F) of tubectomy and vasectomy in urban and rural regions of Iran. Methods A total of 103 450 married women aged 10-49 years in 2005 across urban and rural regions of Iran were sampled by multi stage cluster sampling. The data were collected by household survey and direct interview and analyzed by STATA8.0 software and survey analysis commands. Results Mean age of the women at the time of tubectomy estimated 31.9 years and conversion coefficient of tubectomy was 17.1 ± 0.1. Mean age of women at the time of her husband vasectomy estimated 31.48 years and its conversion coefficient was 17.5 ± 0.1. Cluster analysis defined different regions of Iran on the basis of evaluated conversion coefficients of tubectomy and vasectomy which both of them presented seven clusters. Literacy of women and total coverage of family planning in a region had a direct relationship with this conversion coefficient (P<0.05). Language: English Keywords: IRAN | RESEARCH REPORT | COUPLES | CONTRACEPTION | FAMILY PLANNING | VASECTOMY | TUBAL LIGATION | PROGRAM EVALUATION | Middle East | Developing Countries | Family Characteristics | Family and Household | Sociocultural Factors | Male Sterilization | Sterilization, Sexual | Female Sterilization | Programs | Organization and Administration Document Number: 339900 |
| 3. Title: Hysteroscopic female sterilization with Essure in an outpatient setting. Author: Andersson S; Eriksson S; Mints M Source: Acta Obstetricia Et Gynecologica Scandinavica. 2009;88(6):743-6. Abstract: The aim of this study is to evaluate the short and long-term results of hysteroscopic sterilization in an outpatient setting. Sixty-one women underwent hysteroscopic sterilization. At follow-up, all of the women were asked to complete a questionnaire concerning possible pregnancy, bleeding patterns, side-effects, or need for further therapy after sterilization. Technical feasibility, complications, patient satisfaction, and tubal occlusion based on X-ray or ultrasound were measured. Fifty-eight (95%) women were sterilized according to this method. Successful bilateral device placement was achieved in 52 women (85%) during the first attempt and in six (9.8%) during the second. A total of 50 (81.9%) women submitted completed outcome questionnaires. The mean follow-up period was 23 (range 7-67) months. No pregnancies were reported. All questionnaire respondents expressed overall satisfaction with the procedure. To conclude, Essure sterilization is a safe effective method for female sterilization thatis feasible in the outpatient setting. Language: English Keywords: SWEDEN | RESEARCH REPORT | CLIENTS | FEMALE STERILIZATION | HYSTEROSCOPY | COMPLICATIONS | SIDE EFFECTS | TUBAL OCCLUSION | SATISFACTION | SAFETY | Developed Countries | Europe, Northern | Europe | Program Activities | Programs | Organization and Administration | Sterilization, Sexual | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Treatment | Psychological Factors | Behavior | Public Health Document Number: 341444 |
| 4. Title: Reproductive and hormonal factors, and ovarian cancer risk for BRCA1 and BRCA2 mutation carriers: results from the International BRCA1/2 Carrier Cohort Study. Author: Antoniou AC; Rookus M; Andrieu N; Brohet R; Chang-Claude J Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Feb;18(2):601-10. Abstract: BACKGROUND: Several reproductive and hormonal factors are known to be associated with ovarian cancer risk in the general population, including parity and oral contraceptive (OC) use. However, their effect on ovarian cancer risk for BRCA1 and BRCA2 mutation carriers has only been investigated in a small number of studies. METHODS: We used data on 2,281 BRCA1 carriers and 1,038 BRCA2 carriers from the International BRCA1/2 Carrier Cohort Study to evaluate the effect of reproductive and hormonal factors on ovarian cancer risk for mutation carriers. Data were analyzed within a weighted Cox proportional hazards framework. RESULTS: There were no significant differences in the risk of ovarian cancer between parous and nulliparous carriers. For parous BRCA1 mutation carriers, the risk of ovarian cancer was reduced with each additional full-term pregnancy (P trend = 0.002). BRCA1 carriers who had ever used OC were at a significantly reduced risk of developing ovarian cancer (hazard ratio, 0.52; 95% confidence intervals, 0.37-0.73; P = 0.0002) and increasing duration of OC use was associated with a reduced ovarian cancer risk (P trend = 0.0004). The protective effect of OC use for BRCA1 mutation carriers seemed to be greater among more recent users. Tubal ligation was associated with a reduced risk of ovarian cancer for BRCA1 carriers (hazard ratio, 0.42; 95% confidence intervals, 0.22-0.80; P = 0.008). The number of ovarian cancer cases in BRCA2 mutation carriers was too small to draw definitive conclusions. CONCLUSIONS: The results provide further confirmation that OC use, number of full-term pregnancies, and tubal ligation are associated with ovarian cancer risk in BRCA1 carriers to a similar relative extent as in the general population. Language: English Keywords: DEVELOPED COUNTRIES | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | CROSS-CULTURAL COMPARISONS | CLINICAL RESEARCH | WOMEN | PREVALENCE | RISK ASSESSMENT | OVARIAN CANCER | CHROMOSOME ABNORMALITIES | PARITY | RISK FACTORS | ORAL CONTRACEPTIVES, SIDE EFFECTS | TUBAL LIGATION | Research Methodology | Comparative Studies | Studies | Demographic Factors | Population | Measurement | Evaluation | Cancer | Neoplasms | Diseases | Neonatal Diseases and Abnormalities | Fertility Measurements | Fertility | Population Dynamics | Health | Contraceptive Safety | Safety | Public Health | Female Sterilization | Sterilization, Sexual | Family Planning Document Number: 331025 |
| 5. Title: "Everything I know I learned from my mother...Or not": perspectives of African-American and white women on decisions about tubal sterilization. Author: Borrero S; Nikolajski C; Rodriguez KL; Creinin MD; Arnold RM; Ibrahim SA Source: Journal of General Internal Medicine. 2009 Mar;24(3):312-9. Abstract: BACKGROUND: African-American women have had higher rates of female sterilization compared to white women since its emergence as a contraceptive method. The reasons underlying this observed racial difference are unknown. OBJECTIVES: The goals of this study were to (1) explore what factors shape black and white women's decisions about tubal sterilization as a contraceptive method and (2) generate hypotheses about the relationship of race to the decision-making process. DESIGN: We conducted six focus groups stratified by tubal sterilization status and race. During each of the audio-recorded sessions, participants were asked to discuss reasons that women choose sterilization as a contraceptive method. PARTICIPANTS: The participants of the study were 24 African-American women and 14 white women. APPROACH: Transcripts of the sessions were qualitatively analyzed with particular attention to factors that might be unique to each of the two racial groups. RESULTS: Personal factors shaped black and white women's decisions regarding tubal sterilization. Preference for a convenient, highly effective contraceptive method was the main reason to get a tubal sterilization for women of both racial groups. We also identified socio-cultural differences that might explain why black women are more likely than white women to choose tubal sterilization over other contraceptive methods. An unanticipated, but clinically important, finding was that women often reported feeling that their doctors and the health-care system served as barriers to obtaining the desired procedure. CONCLUSION: Socio-cultural differences may help explain why black and white women choose different contraceptive methods. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | QUALITATIVE RESEARCH | BLACKS | WHITES | WOMEN | TUBAL LIGATION | CONTRACEPTIVE METHODS CHOSEN | DECISION MAKING | SOCIOCULTURAL FACTORS | Developed Countries | North America | Americas | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Female Sterilization | Sterilization, Sexual | Family Planning | Contraceptive Usage | Contraception | Behavior Document Number: 341434 |
| 6. Title: Vasectomy reversal: a seven-year experience. Author: Busato WF Jr Source: Urologia Internationalis. 2009;82(2):170-4. Abstract: INTRODUCTION: Since the demand for vasectomy reversal is increasing and many populations in Brazil and other countries show distinct characteristics, this study was carried out as an effort to determine factors and characteristics associated with the success rate of reversal in a population in Southern Brazil. PATIENTS AND METHODS: We reviewed 29 cases of vasectomy reversal performed over a 7-year period using the single-layer technique under microscopic magnification. RESULTS: Mean patency, pregnancy, and birth rates were 75, 41.7 and 29%, respectively. The patency and pregnancy rates were 92.3 and 38.5%, respectively, for time intervals since vasectomy <10 years and 63.6 and 45.4%, respectively, for intervals >10 years. Patency and pregnancy rates were 87.5 and 50%, respectively, for patients who had their vasectomy performed by a urologist, and 50 and 25%, respectively, for those who had their vasectomy performed by a generalist surgeon (p < 0.05). CONCLUSIONS: High patency and pregnancy rates are associated with time intervals since vasectomy of <10 years and vasectomies performed by urologists. There was no significant difference in the anastomosis time between the first 12 procedures and the next 12 procedures. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | MEN | VASECTOMY | STERILIZATION REVERSAL | PREGNANCY RATE | BIRTH RATE | TIME FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Demographic Factors | Population | Male Sterilization | Sterilization, Sexual | Family Planning | Reversible Sterilization | Fertility Measurements | Fertility | Population Dynamics Document Number: 331231 |
| 7. Title: Male perceptions on female sterilization: a community-based study in rural central India. Author: Char A; Saavala M; Kulmala T Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):131-138. Abstract: CONTEXT: Use of modern contraceptive methods has increased fourfold in India since the 1970s, characterized by a predominance of female sterilization. There has been considerable investigation about women's choice of female sterilization, but little from the male perspective. METHODS: Seven focus group discussions were conducted among 58 men currently married to women aged 15-45, followed by a cross-sectional survey among 793 men currently married to same-aged women. Bivariate analysis was used for the survey data, and content analysis was used for the qualitative data. RESULTS: Men's primary source of reproductive health information was mass media, although they expressed interest in getting information through discussion with knowledgeable sources. Men understood family planning and contraception to be two separate issues: Men viewed "family planning" as synonymous with female sterilization, whereas they saw "contraception" as referring to spacing methods, knowledge of which was limited. Thirty-four percent of men reported that their wives had been sterilized; 79% of men who did not rely on any permanent method said they wanted their wives to be sterilized. In focus group discussions, most men reported themselves as their family's sole decision maker about reproductive health; however, only one-third of survey respondents did so. CONCLUSION: Men are interested in acquiring family planning information, but lack knowledge about available information sources, which hampers their ability to make informed family planning choices. Family planning service providers and program planners need to be aware of males' knowledge and perceptions pertaining to family planning, and make appropriate modifications to communication strategies. Spanish Abstract: Contexto: El uso de métodos anticonceptivos modernos se ha cuadruplicado en India desde los años setenta y se ha caracterizado por el predominio de la esterilización femenina. Ha habido considerables esfuerzos de investigación sobre la elección de la esterilización femenina que hacen las mujeres, pero existen pocos estudios desde la perspectiva masculina. Métodos: Siete sesiones de grupos focales se condujeron con 58 hombres actualmente casados con mujeres en edades de 15-45 años, seguidas por una encuesta transversal aplicada a 793 hombres actualmente casados con mujeres del mismo grupo de edad. Se usó análisis bivariado para los datos de la encuesta y análisis de contenido para los datos cualitativos. Resultados: Para los hombres, la fuente primaria de información sobre salud reproductiva fue los medios masivos, aunque ellos expresaron interés en obtener información a través de charlas con gente informada en el tema. Los hombres encuestados entendieron la planificación familiar y la anticoncepción como dos temas separados: los hombres percibieron la "planificación familiar" como sinónimo de esterilización femenina, mientras que se refirieron a la "anticoncepción" como métodos de espaciamiento, cuyo conocimiento fue limitado. Treinta y cuatro por ciento de los hombres reportaron que sus esposas habían sido esterilizadas; 79% de los hombres que no dependían de algún método permanente dijeron que querían que sus esposas fueran esterilizadas. En las sesiones de grupo, la mayoría de los hombres se identificó como el único tomador de decisiones en su familia respecto a la salud reproductiva; sin embargo, solamente un tercio de los hombres encuestados se identificó de esa forma. Conclusión: Los hombres están interesados en obtener información sobre planificación familiar, pero desconocen las fuentes disponibles que pueden consultar, lo cual limita su capacidad para tomar decisiones informadas sobre planificación familiar. Los prestadores de servicios y planificadores de programas de planificación familiar deben estar conscientes del conocimiento y percepciones de los hombres en relación con la planificación familiar, y realizar las modificaciones apropiadas a sus estrategias de comunicación. French Abstract: Contexte: La pratique de la contraception moderne a quadruplé en Inde depuis les années 1970. Elle se caractérise par une prédominance de la stérilisation féminine. De nombreuses études ont été menées sur le choix féminin de la stérilisation. La perspective masculine n'est en revanche guère connue. Méthodes: Sept réunions de groupe ont été organisées avec 58 hommes mariés à des femmes de 15 à 45 ans. Une enquête transversale a ensuite été menée auprès de 793 hommes mariés à des femmes de la même tranche d'âge. L'analyse bivariée a été utilisée pour les données d'enquête, et l'analyse de contenu pour les données qualitatives. Résultats: Pour les hommes, les médias représentent la principale source d'information sur la santé génésique. Ils expriment cependant un certain intérêt à s'informer par discussion auprès de sources compétentes. Les hommes voient dans la planification familiale et la contraception deux questions distinctes: la «planification familiale» est pour eux synonyme de stérilisation féminine, tandis que la «contraception» désigne les méthodes d'espacement, au sujet desquelles ils ne sont guère informés. Trente-quatre pour cent des hommes ont déclaré que leur femme était stérilisée; 79% de ceux qui n'avaient pas eu recours à une méthode permanente ont indiqué désirer que leur femme se fasse stériliser. Lors des discussions de groupe, la plupart des hommes se sont déclarés les seuls décideurs de leur famille en matière de santé génésique, par rapport à un tiers seulement des répondants à l'enquête. Conclusion: Les hommes désirent s'informer sur la planification familiale mais ils ignorent les sources d'information disponibles, ce qui entrave leur aptitude à opérer des choix éclairés en la matière. Les prestataires de services et les planifi- cateurs de programmes de planification familiale doivent être sensibles aux connaissances et aux perceptions masculines et ajuster en conséquence leurs stratégies de communication. Language: English Keywords: INDIA | RESEARCH REPORT | FOCUS GROUPS | CROSS SECTIONAL ANALYSIS | MEN | CURRENTLY MARRIED | REPRODUCTIVE HEALTH | PERCEPTION | FEMALE STERILIZATION | INFORMATION SOURCES | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Demographic Factors | Population | Marital Status | Nuptiality | Health | Psychological Factors | Behavior | Sterilization, Sexual | Family Planning | Information Document Number: 343003 |
| 8. Peer Reviewed Title: Contraceptive discontinuation and non-use in Santarem, Brazilian Amazon. Author: D'Antona Ade O; Chelekis JA; D'Antona MF; Siqueira AD Source: Cadernos De Saude Publica. 2009 Sep;25(9):2021-32. Abstract: In this paper we discuss the causes of non-adherence to reversible contraceptives, especially hormonal methods, among women in rural Santarem in the Brazilian Amazon. The analysis is based on questionnaires with 398 women and visits to health centers. We consider the motives reported by women who: never used contraception; used some method in the past; and who at the time of the survey were using a different method from the ones they used in the past. The results indicate a rejection of hormonal contraception and a preference for female sterilization, an option possibly influenced by the characteristics of health services in the region. The side effects of hormonal contraceptive use reported by part of the interviewees contribute to a generalized fear of the side effects even among women who have never used such methods. To improve women's health services in the Amazon, we recommend further studies of the relationship between reported side effects and available services and prescriptions, as well as an analysis of women's discourse and perceptions. Language: English Keywords: BRAZIL | RURAL AREAS | RESEARCH REPORT | WOMEN | CONTRACEPTION TERMINATION | CONTRACEPTIVE METHODS CHOSEN | MOTIVATION | CONTRACEPTIVE AGENTS, FEMALE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | FEAR | FEMALE STERILIZATION | CONDOM USE | CONTRACEPTIVE PREVALENCE | PROGRAM ACCESSIBILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Geographic Factors | Population | Demographic Factors | Contraception | Family Planning | Contraceptive Usage | Psychological Factors | Behavior | Contraceptive Agents | Emotions | Sterilization, Sexual | Risk Reduction Behavior | Program Evaluation | Programs | Organization and Administration Document Number: 342777 |
| 9. Peer Reviewed Title: Quinacrine sterilization for human immunodeficiency virus-positive women. Author: de Magalhaes DR; de Carvalho Ferreira CR; Barbosa Magalhaes E; Camargos AF; Lippes J; Carvalho Ferreira D Source: Fertility and Sterility. 2009 Jul;92(1):108-15. Abstract: OBJECTIVE: To evaluate the safety of nonsurgical quinacrine sterilization for HIV-positive (HIV+) women. DESIGN: An open trial of quinacrine sterilization was carried out in women infected with HIV and women who were HIV negative (HIV-). Comparison of the results with the two groups provided an assessment of the safety and effectiveness of quinacrine sterilization for HIV+ women. SETTING: University Medical School outpatient services. PATIENT(S): A total of 258 women who desired sterilization were offered quinacrine sterilization as a means of limiting family size. Sixty-four were HIV+, and 194 were HIV-. Women who were HIV+ had CD4 counts >200 and were otherwise healthy. INTERVENTION(S): A modified Copper T intrauterine device inserter was used to place 252 mg of quinacrine, divided into seven pellets (36 mg each) into the uterine cavity. Three insertions of this formulation were performed, 1 month apart. Viral load and CD8 and CD4 lymphocytes were measured both before and after quinacrine sterilization and at follow-up visits. Pregnancies and adverse events were recorded carefully. A decrement life table was made to statistically analyze results. RESULT(S) AND MAIN OUTCOME MEASURE(S): No serious adverse event occurred in any patient in this study. Adverse effects related to quinacrine sterilization were abdominal cramping, vulvar itching, nausea, and vaginal bleeding. Vaginal bleeding was the only short-term side effect noted to occur more frequently in HIV-infected women after quinacrine sterilization. Among HIV+ women, 35.9% had complaints of increased bleeding, whereas only 8.2% of those who were HIV- had such complaints, which probably were insertion related. Viral load and the CD4+ and CD8+ lymphocyte measures displayed no statistically significant difference after quinacrine sterilization. CONCLUSION(S): Quinacrine sterilization is a safe method for the sterilization of HIV-infected women and has no short-term effect on the pathology of the disease. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL TRIALS | PERSONS LIVING WITH HIV/AIDS | WOMEN | QUINACRINE STERILIZATION | SAFETY | ANTIRETROVIRAL THERAPY | SIDE EFFECTS | INSERTION | ULTRASONICS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Clinical Research | Research Methodology | HIV Infections | Viral Diseases | Diseases | Demographic Factors | Population | Female Sterilization | Sterilization, Sexual | Family Planning | Public Health | Health | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 342325 |
| 10. Title: High and low frequency TENS reduce postoperative pain intensity after laparoscopic tubal ligation: a randomized controlled trial. Author: Desantana JM; Sluka KA; Lauretti GR Source: Clinical Journal of Pain. 2009 Jan;25(1):12-9. Abstract: BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is an effective adjunctive therapy for postoperative pain; however, effects of different frequencies of stimulation have not been systematically investigated. Laparoscopic sterilization (LS) causes significant pain in the early postoperative period and requires substantial postoperative medication. Therefore, we studied the effects of TENS on postoperative pain after LS through placement of Yoon fallopian rings in a prospective, randomized, double-blinded, and placebo-controlled study. METHODS: Sixty-four patients undergoing LS for uterine tube ligation were randomly allocated to receive either active TENS or placebo TENS. Postoperative pain was evaluated using a standard 11-point numeric rating scale and the McGill Pain Questionnaire (MPQ)-pain rating index and number of words chosen. Both high frequency (100 Hz) and low frequency (4 Hz) TENS, at strong, but comfortable sensory intensity, were applied for 20 minutes through 4 electrodes placed around the surgical incision immediately after surgery. Pain was assessed before and after application of TENS when patients were at postanesthesia care unit (PACU). RESULTS: Both high and low frequency TENS significantly decreased postoperative pain intensity when compared with before administration of TENS using the numeric rating scale (P=0.001), pain rating index (P=0.001), and number of words chosen (P=0.001) compared with placebo TENS (P=0.001). TENS in combination with standard pharmacologic analgesic treatment was efficacious for postoperative pain relief after LS. CONCLUSIONS: We recommend regular use of multimodal therapy with TENS and analgesic drugs after LS with placement of Yoon rings. Language: English Keywords: BRAZIL | RESEARCH REPORT | DOUBLE-BLIND STUDIES | CLIENTS | TUBAL LIGATION | LAPAROSCOPY | PAIN | MEDICAL PROCEDURES | ANALGESIA | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Female Sterilization | Sterilization, Sexual | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Treatment Document Number: 341433 |
| 11. Title: Use of oral contraceptives, intrauterine devices and tubal sterilization and cancer risk in a large prospective study, from 1996 to 2006. Author: Dorjgochoo T; Shu XO; Li HL; Qian HZ; Yang G; Cai H; Gao YT; Zheng W Source: International Journal of Cancer. 2009;124(10):2442-2449. Abstract: The association of contraceptive methods, including oral contraceptives (OC), intrauterine devices (IUD) and tubal sterilization (TS), with overall and site-specific cancer were prospectively investigated in a cohort of 66,661 Chinese women in Shanghai, 76.7% of whom used contraception. During a median follow-up time of 7.5 years, 2,250 women were diagnosed with cancer. Ever-use of any contraceptive method was not associated with overall cancer risk [adjusted hazard ratio (HR(adj)) = 1.02, 95% CI, 0.92-1.12]. Use of any contraceptive method was associated with increased risk of rectal cancer (HR(adj) = 1.68, 95% CI, 1.08-2.62) and reduced risk of thyroid cancer (HR(adj) = 0.63, 95% CI, 0.38-1.04). Risk of gallbladder cancer increased with ever use of OC (HR(adj) = 2.38, 95% CI, 1.26-4.49). IUD use was associated with a possible reduced risk of thyroid cancer (HR(adj) = 0.64, 95% CI, 0.38-1.07). Longer duration of IUD use decreased risk for breast, thyroid and lung cancers. Ever having a TS was associated with increased uterine body cancer (HR(adj) = 2.50, 95% CI, 1.47-4.25) and decreased risk of stomach cancer (HR(adj) = 0.59, 95% CI, 0.39-0.91). We did not find any contraceptive method to be related to the risk of ovarian cancer but the analyses were based on few events. Although chance findings are a likely explanation for some of the associations found in our study, these findings suggest that various contraceptive methods or reproductive patterns may play a role in the etiology of cancer. (c) 2008 Wiley-Liss, Inc. Language: English Keywords: UNITED STATES OF AMERICA | CHINA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | IUD | NEOPLASMS | FEMALE STERILIZATION | TUBAL LIGATION | Developed Countries | North America | Americas | Asia, Eastern | Asia | Developing Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Diseases | Sterilization, Sexual Document Number: 329657 |
| 12. Peer Reviewed Title: Tubal sterilization by laparoscopy or hysteroscopy: which is the most cost-effective procedure? Author: Franchini M; Cianferoni L; Lippi G; Calonaci F; Calzolari S; Mazzini M; Florio P Source: Fertility and Sterility. 2009 Apr;91(4 Suppl):1499-502. Abstract: By using the activity-based cost/management (ABC/M) system we computed and compared costs needed for laparoscopic tubal sterilization (LTS) and Essure hysteroscopic tubal occlusion (EHTO). We found that total health costs related to consultation and presurgery did not differ between LTS and EHTO; EHTO has low recovery unit costs but is more costly for the operating theater, mainly due to Essure microinserts. Language: English Keywords: UNITED STATES OF AMERICA | ITALY | RESEARCH REPORT | WOMEN | TUBAL LIGATION | FEMALE STERILIZATION | SURGERY | COST BENEFIT ANALYSIS | TREATMENT | DELIVERY OF HEALTH CARE | MANAGEMENT | LOGISTICS | SCREENING | PROGRAM EFFICIENCY | Developed Countries | North America | Americas | Europe, Southern | Europe | Demographic Factors | Population | Sterilization, Sexual | Family Planning | Medical Procedures | Medicine | Health Services | Health | Quantitative Evaluation | Evaluation | Organization and Administration | Examinations and Diagnoses | Program Evaluation | Programs Document Number: 341007 |
| 13. Peer Reviewed Title: Development of a scrotal vasocutaneous fistula producing viable spermatozoa 9 years after vasectomy. Author: Gaden S; Kasraie J Source: Fertility and Sterility. 2009 Mar;91(3):929.e17-9. Abstract: OBJECTIVE: To describe a case of scrotal vasocutaneous fistula discharging viable sperm. DESIGN: Case report. SETTING: A hospital-based assisted conception center. PATIENT(S): A 37-year-old male presenting for fertility treatment 9 years after vasectomy with a scrotal vasocutaneous fistula that caused a painful, intermittently rupturing, subcutaneous cyst. INTERVENTION(S): Analysis of fistula discharge and planned fistula resection with vasovasostomy. MAIN OUTCOME MEASURE(S): Diagnostic semen analysis to determine presence or absence of spermatozoa in fistula discharge. RESULT(S): A very low concentration of live spermatozoa were identified in the fistula discharge. CONCLUSIONS(S): We believe this is the first time that live spermatozoa, potentially suitable for assisted conception treatment using intracytoplasmic sperm injection have been identified in the discharge from a vasocutaneous fistula. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | CASE STUDIES | MEN | VASECTOMY | SPERMATOZOA | FISTULA | TREATMENT | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Male Sterilization | Sterilization, Sexual | Family Planning | Germ Cells | Genitalia | Urogenital System | Physiology | Biology | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341006 |
14.  Title: [Descriptive study on contraceptive requirements for clinical trials in Spain. Do we need a debate?] Estudio descriptivo de las recomendaciones anticonceptivas en los ensayos Author: Gastaminza Lasarte G; Algorta Pineda J Source: Medicina Clinica. 2009 Jan 24;132(2):70-4. Abstract: Among the measures that seek to avoid the toxic effects on reproduction (teratogenic, embryotoxic, fetotoxic or otherwise) include the obligation to conduct preclinical tests to investigate this aspect in different animal species before marketing a new drug, although its application in time differs Europe-European Medicines Agency (EMEA) and US-Food and Drug Administration (FDA). In Europe requires that prior to including women in phase I of clinical trials have been completed preclinical studies on embryo-fetal development, without any mention of contraception. In contrast, U.S. can include women in the fertile clinical trials have not completed initial pre-clinical tests on the safety play, if they practice a pregnancy test before participation in contraception and take some action "highly effective". Are considered "highly effective" (by both the FDA and the EMEA, to be included in a document of the International Conference on Harmonization) methods with low failure rate (<1% per year) when used properly, such as implants, injectables, combined oral, some intrauterine devices (IUDs), sexual abstinence or a vasectomy for the partner. (excerpt) Language: Spanish Keywords: SPAIN | RESEARCH REPORT | CLINICAL TRIALS | PREGNANCY TESTS | ORAL CONTRACEPTIVES, COMBINED | IUD | INJECTABLES | CONTRACEPTIVE IMPLANTS | VASECTOMY | Europe, Southwestern | Europe | Developed Countries | Clinical Research | Research Methodology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Male Sterilization | Sterilization, Sexual Document Number: 329576 |
| 15. Peer Reviewed Title: Multicenter Contraceptive Efficacy Trial of Injectable Testosterone Undecanoate in Chinese Men. Author: Gu Y; Liang X; Wu W; Liu M; Song S; Cheng L; Bo L; Xiong C; Wang X; Liu X; Peng L; Yao K Source: Journal of Clinical Endocrinology and Metabolism. 2009 Jun;94(6):1910-1915. Abstract: Context: Hormonal male contraceptive regimens effectively and reversibly suppress sperm production but there are few large-scale efficacy studies. Objective: The safety, contraceptive efficacy, reversibility and feasibility of injectable testosterone undecanoate (TU) in tea seed oil as a hormonal male contraceptive was assessed. Design: This was a mutilcenter, phase III, contraceptive efficacy clinical trial. Participants: 1045 healthy fertile Chinese men were recruited throughout China into the study. Intervention(s): Monthly injections of 500 mg TU, administered for 30 months. A definition of severe oligozoospermia (Language: English Keywords: CHINA | RESEARCH REPORT | CLINICAL TRIALS | MEN | INJECTABLES | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE AGENTS, MALE | CONTRACEPTIVE SAFETY | REVERSIBLE STERILIZATION | ADMINISTRATION AND DOSAGE | SPERMATOGENESIS BLOCKING AGENTS | TESTIS | SEMEN | HORMONES | TIME FACTORS | Asia, Eastern | Asia | Developing Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Safety | Public Health | Health | Sterilization, Sexual | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Seminal Vesicles | Endocrine System | Population Dynamics Document Number: 330735 |
| 16. Peer Reviewed Title: In vitro testing of rationally designed spermicides for selectively targeting human sperm in vagina to ensure safe contraception. Author: Jain RK; Jain A; Maikhuri JP; Sharma VL; Dwivedi AK; Kumar ST; Mitra K; Bajpai VK; Gupta G Source: Human Reproduction. 2009 Mar;24(3):590-601. Abstract: BACKGROUND: Rational synthesis of novel structures resulted in two unique molecules (DSE-36 and DSE-37, disulphide esters of carbothioic acid) that killed sperm 25 times more strongly and with a precisely targeted action than nonoxynol-9 (N-9). We examine the effects of DSE-36 and DSE-37 on human spermatozoa versus HeLa cells to establish specificity and safety compared with N-9. METHODS AND RESULTS: At spermicidal EC(100) (20 microg/ml) DSE-36 and DSE-37 killed 100% sperm in <30 s (Sander-Cramer assay) and at EC(50) induced apoptosis in sperm (Annexin-V-fluorescein isothiocyanate and JC-1 labelling and Flow Cytometry) in 3 h. However, at EC(100) these molecules had no effect on HeLa cells by 24 h or on cell viability [3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay], surface ultrastructure (scanning electron microscopy), Annexin-V and JC-1 labelling pattern and reactive oxygen species (ROS) generation. N-9, with a spermicidal EC(100) of 500 microg/ml, decreased HeLa cell viability at 20 microg/ml in 24 h (P < 0.001), accompanied by acute damage to cell surface ultrastructural topography, induction of apoptosis and ROS generation. Unlike DSE-36 and DSE-37, N-9 also significantly induced mRNA levels (RT-PCR) of pro-inflammatory biomarkers (interleukin (IL)-1 alpha, IL-6, IL-8, RANTES) in HeLa cells and increased IL-6 and IL-8 secretion (P < 0.001, enzyme-linked immunosorbent assay). Furthermore, DSE-36 and DSE-37 did not inhibit Lactobacillus growth at EC(100) and exhibited mild microbicidal activity against Trichomonas vaginalis, while N-9 inhibited Lactobacillus and Trichomonas growth but had a lower prophylactic index. CONCLUSIONS: The ability of these novel spermicides to kill sperm almost instantaneously at innocuously low concentration indicates their worth as improved active ingredients for vaginal contraceptive preparations compared with N-9. Language: English Keywords: INDIA | RESEARCH REPORT | WOMEN | SPERMICIDAL CONTRACEPTIVE AGENTS | CONTRACEPTION | NONOXYNOL | CONTRACEPTIVE SAFETY | VAGINAL APPROACH | PROGRAM EFFECTIVENESS | Asia, Southern | Asia | Developing Countries | Demographic Factors | Population | Contraceptive Agents | Family Planning | Alcohols | Organic Chemicals | Ingredients and Chemicals | Safety | Public Health | Health | Female Sterilization | Sterilization, Sexual | Program Evaluation | Programs | Organization and Administration Document Number: 342583 |
| 17. Title: Long-acting, reversible and permanent methods of contraception: insight into women's choice of method. Author: Kane R; Irving G; Brown S; Parkes N; Walling M; Killick S Source: Quality In Primary Care. 2009;17(2):107-14. Abstract: BACKGROUND: This study aims to explore the views of women concerning their choice of long-acting method of contraception. METHOD: Two-hundred and eighty-six women who had either been sterilised or fitted with an etonorgestrel (ETN) implant or the levonorgestrel intrauterine system (LNG IUS) were invited to take part. A response rate of 54% was achieved. Women from all three groups reported positive and negative experiences with their chosen method. RESULTS: Women frequently choose sterilisation specifically because it is irreversible, does not involve hormonal treatment, and they do not wish to retain choice of future fertility. Women incorrectly regard sterilisation as more reliable than any reversible method. Regret after sterilisation was common, even if this was preceded by full counselling. Even among patients of practices with a special interest in family planning, long-acting methods, although available, were not widely known about. CONCLUSION: This study suggests that women chose sterilisation for one of three main reasons: to avoid the possible side-effects of hormones; to avoid continually having to make decisions regarding child-bearing; and/or a lack of information regarding reversible methods. Sterilisation is often chosen by women specifically because of its irreversibility. This may explain why long-acting reversible methods have remained relatively unpopular. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | WOMEN | REVERSIBILITY | CONTRACEPTION | STERILIZATION REVERSAL | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Family Planning | Reversible Sterilization | Sterilization, Sexual Document Number: 341053 |
| 18. Title: Transvaginal endoscopic tubal sterilization. Author: Kondo W; Noda RW; Branco AW; Rangel M; Branco Filho AJ Source: Journal of Laparoendoscopic and Advanced Surgical Techniques. Part A. 2009 Feb;19(1):59-61. Abstract: BACKGROUND: Tubal sterilization is one of the most widely used options for female contraception. It can be performed by laparotomy, minilaparotomy, colpotomy, laparoscopy, and hysteroscopy. In this paper, we report the use of the transvaginal endoscopic approach to perform tubal ligation. CASE: The access to the abdomen was obtained by a 1.5-cm colpotomy. The flexible endoscope was introduced into the peritoneal cavity, and carbon dioxide was instilled to get the pneumoperitoneum. Fallopian tubes were identified and electrocauterized with a 40-W coagulation current. Total procedure time was 45 minutes. A single dose of intravenous dypirone was administered for pain. She was discharged 10 hours after the procedure. CONCLUSION: Transvaginal endoscopic tubal ligation is feasible and can be considered an alternative approach to perform female sterilization. Language: English Keywords: BRAZIL | SUMMARY REPORT | CASE HISTORIES | CLIENTS | TUBAL LIGATION | COLPOTOMY | ENDOSCOPY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Female Sterilization | Sterilization, Sexual | Family Planning | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physical Examinations and Diagnoses | Examinations and Diagnoses Document Number: 341431 |
| 19. Peer Reviewed Title: Trials for development of once-a-month injectable, hormonal male contraceptive using dienogest plus testosterone undecanoate: dose standardization, efficacy and reversibility studies in rats. Author: Misro MM; Chaki SP; Kaushik MC; Nandan D Source: Contraception. 2009 Jun;79(6):488-97. Abstract: BACKGROUND: The study was conducted to test the potential of using dienogest (DNG) plus testosterone undecanoate (TU) in rats for development of a once-a-month injectable male hormonal contraceptive. STUDY DESIGN: Dose selection studies were initiated with administration of DNG in three different doses of 20, 30 and 40 mg/kg body weight (bw) per week plus TU 25 mg/kg bw once in every 6 weeks. Status of spermatogenesis and sperm count in epididymis was evaluated. The frequency of DNG intervention was later extended to every 2- and 4-week intervals. Mating studies, toxicity and reversibility of spermatogenesis following stoppage of treatment were carried out with DNG 40 mg/kg bw at 4-week intervals. RESULTS: Complete arrest of spermatogenesis was observed after 60 days of treatment at all doses of DNG (20, 30 and 40 mg/kg bw per week)+TU. However, weights of testis and accessory sex organs (epididymis, prostate and seminal vesicle) declined significantly 60 days post treatment compared to vehicle-treated controls. Epididymis in the treated animals was completely devoid of sperm. When the frequency of DNG injection (20 mg/kg bw) was extended to once every 15 days, a few immotile and decapitated sperm were observed in the epididymis. With TU treatment unchanged, animals receiving DNG (40 mg/kg bw) once either every 2- or 4-week intervals demonstrated good and uniform arrest of spermatogenesis. DNG 40 mg/kg per 4 weeks+TU also demonstrated a significant rise in germ cell apoptosis in the seminiferous epithelium. There was no significant increase in the serum high-density lipoprotein and low-density lipoprotein levels at the end of 120 days of treatment. Following withdrawal of treatment after 60 or 120 days, qualitative restoration of spermatogenesis was rapid in the former compared to the latter. CONCLUSION: Dienogest plus TU has the potential for development as a monthly injectable showing reversible hormonal male contraception with good efficacy. Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | LABORATORY ANIMALS | MEN | INJECTABLES | TESTOSTERONE | ADMINISTRATION AND DOSAGE | STANDARDIZATION | REVERSIBLE STERILIZATION | MALE CONTRACEPTION | BODY WEIGHT | TIME FACTORS | SPERMICIDAL CONTRACEPTIVE AGENTS | Asia, Southern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Androgens | Hormones | Endocrine System | Physiology | Biology | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Data Adjustment | Sterilization, Sexual | Population Dynamics | Contraceptive Agents Document Number: 341101 |
| 20. Peer Reviewed Title: Ovarian cancer risk factors in African-American and white women. Author: Moorman PG; Palmieri RT; Akushevich L; Berchuck A; Schildkraut JM Source: American Journal of Epidemiology. 2009 Sep 1;170(5):598-606. Abstract: Ovarian cancer is the most lethal gynecologic malignancy in both African-American and white women. Although prevalences of many ovarian cancer risk factors differ markedly between African Americans and whites, there has been little research on how the relative contributions of risk factors may vary between racial/ethnic groups. Using data from a North Carolina case-control study (1999-2008), the authors conducted unconditional logistic regression analyses to calculate odds ratios and 95% confidence intervals for ovarian cancer risk factors in African-American (143 cases, 189 controls) and white (943 cases, 868 controls) women and to test for interactions by race/ethnicity. They also calculated attributable fractions within each racial/ethnic group for the modifiable factors of pregnancy, oral contraceptive use, tubal ligation, and body mass index. Many risk factors showed similar relations across racial/ethnic groups, but tubal ligation and family history of breast or ovarian cancer showed stronger associations among African Americans. Younger age at menarche was associated with risk only in white women. Attributable fractions associated with tubal ligation, oral contraceptive use, and obesity were markedly higher for African Americans. The relative importance of ovarian cancer risk factors may differ for African-American women, but conclusions were limited by the small sample. There is a clear need for further research on etiologic factors for ovarian cancer in African-American women. Language: English Keywords: UNITED STATES OF AMERICA | NORTH CAROLINA | RESEARCH REPORT | CONTROL GROUPS | WOMEN | BLACKS | WHITES | OVARIAN CANCER | RISK FACTORS | ORAL CONTRACEPTIVES | TUBAL LIGATION | OBESITY | BREASTFEEDING | GENETICS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Cancer | Neoplasms | Diseases | Health | Contraceptive Methods | Contraception | Family Planning | Female Sterilization | Sterilization, Sexual | Body Weight | Physiology | Biology | Infant Nutrition | Nutrition Document Number: 342784 |
| 21. Title: Gene knockouts that affect male fertility: novel targets for contraception. Author: Naz RK; Engle A; None R Source: Frontiers In Bioscience. 2009;14:3994-4007. Abstract: There is an urgent need for a better method of contraception that is accepted, effective, and available, due the population explosion and unintended pregnancy. Various targets are being investigated that can be used for contraception. The ideal target should be non-steroidal, intercourse-independent, non-surgical, reversible, and non-barrier with no side effects. The gene knockout technology is a powerful approach to identify such novel targets. We identified at least 93 genes whose deletion demonstrated an effect on fertility in male mice till 2004 (1). In the present article, we found 71 additional gene knockouts in the database since the last report which demonstrated an effect on male fertility. The majority of these knockouts also demonstrated an effect on non-reproductive organs concomitant with an anti-fertility effect or effect on other organs was not examined. The knockouts of only a few genes/proteins induced a specific effect on fertility without a serious side effect. These genes/proteins may provide novel targets for contraception/contraceptive vaccine development. Language: English Keywords: WEST VIRGINIA | RESEARCH REPORT | CLINICAL RESEARCH | MEN | LABORATORY ANIMALS | GENETICS | REPRODUCTIVE BEHAVIOR | SEX BEHAVIOR | REVERSIBLE STERILIZATION | MALE STERILIZATION | CHROMOSOME ABNORMALITIES | PROTEINS | CONTRACEPTIVE VACCINES | Developed Countries | United States of America | North America | Americas | Research Methodology | Demographic Factors | Population | Biology | Fertility | Population Dynamics | Behavior | Sterilization, Sexual | Family Planning | Neonatal Diseases and Abnormalities | Diseases | Physiology | Contraception, Immunological | Contraception Document Number: 330601 |
| 22. Title: Update on male contraception. Author: Naz RK; Rowan S Source: Current Opinion In Obstetrics and Gynecology. 2009 Jun;21(3):265-9. Abstract: PURPOSE OF REVIEW: To review current options of contraception available for men and the recent developments in the field of male contraception. RECENT FINDINGS: Current options for male contraception are the barrier methods such as condoms and the surgical methods such as vasectomy. Condoms are coital-dependent and not always reliable as they are prone to slippage and breakage. Vasectomy has the advantage of being coital-independent but is permanent. Recent surveys have shown that men want to be more involved in contraception decisions, and women trust their male partners to take an active role in this area. Nonsurgical steroidal methods comprising various derivatives of the androgens and their receptors are in various phases of clinical trials in men. The ideal male contraceptive should be coitalin-dependent, nonsurgical, reversible, effective, and should not alter androgen levels or libido. Several nonsteroidal molecules and vaccines are being investigated in animal models for male contraception. SUMMARY: Male hormonal contraception may become a reality in the near future. Nonsteroidal methods including contraceptive vaccines targeting various molecules are an exciting proposition and are under investigation. Language: English Keywords: UNITED STATES OF AMERICA | WEST VIRGINIA | RESEARCH REPORT | MEN | BARRIER METHODS | CONDOMS | VASECTOMY | MALE CONTRACEPTION | CONTRACEPTIVE VACCINES | TESTOSTERONE | Developed Countries | North America | Americas | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Male Sterilization | Sterilization, Sexual | Contraception, Immunological | Androgens | Hormones | Endocrine System | Physiology | Biology Document Number: 341313 |
| 23. Title: An African perspective on mucosal immunity and HIV-1. Author: Pala P; Gomez-Roman VR; Gilmour J; Kaleebu P Source: Mucosal Immunology. 2009 Jul;2(4):300-14. Abstract: HIV prevention mandates an understanding of the mechanisms of mucosal immunity with attention to some unique features of the epidemic and mucosal environment in the developing world. An effective vaccine will have to induce mucosal protection against a highly diverse virus, which is equipped with a number of immune evasion strategies. Its development will require assessment of mucosal immune responses, and it will have to protect a mucosal environment where inflammation and altered immune responses are common because of the presence of other mucosal infections, such as sexually transmitted infections and parasites, and where nutritional status may also be compromised. Ideally, not only prevention methods would protect adults but also provide cover against gastrointestinal transmission through maternal milk. Prevention might also be complemented by microbicides and circumcision, two alternative approaches to mucosal protection. It seems unlikely that a single solution will work in all instances and intervention might have to act at multiple levels and be tailored to local circumstances. We review here some of the mucosal events associated with HIV infection that are most relevant in an African setting. Language: English Keywords: AFRICA | RESEARCH REPORT | HIV PREVENTION | MICROBICIDES | VAGINAL APPROACH | AUTOIMMUNE RESPONSE | GASTROINTESTINAL EFFECTS | Developing Countries | HIV Infections | Viral Diseases | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Female Sterilization | Sterilization, Sexual | Family Planning | Antibodies | Immunologic Factors | Immunity | Immune System | Physiology | Biology Document Number: 342694 |
| 24. Title: Transcervical sterilization: a comparison of essure(r) permanent birth control system and adiana(r) permanent contraception system. Author: Palmer SN; Greenberg JA Source: Reviews In Obstetrics and Gynecology. 2009 Spring;2(2):84-92. Abstract: Transcervical sterilization has moved female sterilization from a minimally invasive laparoscopic technique, which requires entry into the abdominal cavity, to a less invasive hysteroscopic procedure. Along with the decreased potential for complications, its ease of performance with minimal anesthesia has facilitated a move from the operating room to the office. This review compares the available data on transcervical sterilization procedures to better understand the strengths and weakness of each system. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | CONTRACEPTION RESEARCH | FEMALE CONTRACEPTION | CERVIX | LAPAROSCOPY | FEMALE STERILIZATION | TUBAL OCCLUSION | USFDA | PRODUCT APPROVAL | Developed Countries | North America | Americas | Contraception | Family Planning | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sterilization, Sexual | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Legislation Document Number: 342044 |
| 25. Title: Formulation and Performance Characterization of Radio-Sterilized "Progestin-Only" Microparticles Intended for Contraception. Author: Puthli S; Vavia P Source: AAPS PharmSciTech. 2009 Apr 21; Abstract: The aim of this study was to formulate and characterize a microparticulate system of progestin-only contraceptive. Another objective was to evaluate the effect of gamma radio-sterilization on in vitro and in vivo drug release characteristics. Levonorgestrel (LNG) microspheres were fabricated using poly(lactide-co-glycolide) (PLGA) by a novel solvent evaporation technique. The formulation was optimized for drug/polymer ratio, emulsifier concentration, and process variables like speed of agitation and evaporation method. The drug to polymer ratio of 1:5 gave the optimum encapsulation efficiency. Speed of agitation influenced the spherical shape of the microparticles, lower speeds yielding less spherical particles. The speed did not have a significant influence on the drug payloads. A combination of stabilizers viz. methyl cellulose and poly vinyl alcohol with in-water solvent evaporation technique yielded microparticles without any free drug crystals on the surface. This aspect significantly eliminated the in vitro dissolution "burst effect". The residual solvent content was well within the regulatory limits. The microparticles passed the test for sterility and absence of pyrogens. In vitro dissolution conducted on the product before and after gamma radiation sterilization at 2.5 Mrad indicated no significant difference in the drug release patterns. The drug release followed zero-order kinetics in both static and agitation conditions of dissolution testing. The in vivo studies conducted in rabbits exhibited LNG release up to 1 month duration with drug levels maintained within the effective therapeutic window. Language: English Keywords: INDIA | RESEARCH REPORT | EVALUATION | WOMEN | CONTRACEPTIVE AGENTS, PROGESTIN | ANALYSIS | FEMALE STERILIZATION | LEVONORGESTREL | LABORATORY PROCEDURES | INJECTABLES | Asia, Southern | Asia | Developing Countries | Demographic Factors | Population | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Research Methodology | Sterilization, Sexual | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods Document Number: 331124 |
| 26. Peer Reviewed Title: Factors predictive for failure to perform postpartum tubal ligations following vaginal delivery. Author: Seibel-Seamon J; Visintine JF; Leiby BE; Weinstein L Source: Journal of Reproductive Medicine. 2009 Mar;54(3):160-4. Abstract: OBJECTIVE: To identify patients requesting postpartum sterilization and compare those who underwent the procedure with those who did not. STUDY DESIGN: A retrospective study of requested postpartum tubal ligations was completed. Demographics and clinical characteristics were analyzed. We analyzed whether the failure to obtain postpartum sterilization resulted in an interval laparoscopic tubal ligation or future pregnancy. RESULTS: A total of 135 women requested sterilization, but only 56% received the desired procedure. Time of delivery (OR 2.23, CI 1.08-4.58), body mass index (OR 2.38, CI 1.10-5.16) and gravidity (OR 0.80, CI 0.65-0.97) were significant variables that were different between the 2 groups. Of the women who left the hospital postpartum without a sterilization procedure, 44% received an interval laparoscopic tubal ligation and 18% later became pregnant. CONCLUSION: Postpartum tubal ligations are often not performed despite patient request. Additional measures should be undertaken to ensure that patient requests for postpartum tubal ligation are implemented. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLIENTS | POSTPARTUM WOMEN | TUBAL LIGATION | FEMALE STERILIZATION | LAPAROSCOPY | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Puerperium | Reproduction | Sterilization, Sexual | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341445 |
| 27. Peer Reviewed Title: Vasectomy under local anaesthesia performed free of charge as a family planning service: complications and results. Author: Trollip GS; Fisher M; Naidoo A; Theron PD; Heyns CF Source: South African Medical Journal. 2009 Apr;99(4):238-42. Abstract: OBJECTIVE: To evaluate the safety and efficacy of vasectomy performed under local anaesthesia by junior doctors at a secondary level hospital as part of a free family planning service. METHOD: Men requesting vasectomy were counselled and given written instructions to use alternative contraception until two semen analyses 3 and 4 months after vasectomy had confirmed azoospermia. Bilateral vasectomy was performed as an outpatient procedure under local anaesthesia by junior urology registrars. Statistical analysis was performed using the Mann-Whitney, Kruskal-Wallis, Fisher's exact or Spearman's rank correlation tests as appropriate. RESULTS: Between January 2004 and December 2005, 479 men underwent vasectomy at Karl Bremer Hospital, Western Cape, South Africa; their average age was 36.1 (range 21 - 66) years, they had a median of 2 (range 0 - 10) children, and only 19% had 4 or more children. The average operation time was 15.5 (range 5 - 53) minutes. Complications occurred in 12.9%; these were pain(7.3%), swelling (5.4%), haematoma (1.3%), sepsis (1%), difficulty locating the vas (1%), vasovagal episode (0.6%), bleeding (0.6%), wound rupture (0.4%) and dysuria (0.2%) (some men had more than one complication). Of the men 63.3% returned for one semen analysis and 17.5% for a second. The vasectomy failure rate ranged from 0.4% (sperm persisting > 365 days after vasectomy) to 2.3% (sperm seen > 180 days after vasectomy and/or in the second semen specimen). No pregnancies were reported. The complication (5.6%) and failure rates (0%) were lowest for the registrar who had performed the smallest number of vasectomies and whose average operation time was longest. Comparing the first one-third of procedures performed by each of the doctors with the last one-third, there was a significant decrease in average operating times but not in complication rates. CONCLUSIONS: Vasectomy can be performed safely and effectively by junior doctors as an outpatient procedure under local anaesthesia, and should be actively promoted in South Africa as a safe and effective form of male contraception. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CLIENTS | VASECTOMY | ANESTHESIA | FAMILY PLANNING PROGRAMS | HOSPITALS | COMPLICATIONS | BLEEDING | PAIN | SAFETY | SURGERY | TIME FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Program Activities | Programs | Organization and Administration | Male Sterilization | Sterilization, Sexual | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Health Facilities | Diseases | Signs and Symptoms | Public Health | Population Dynamics | Demographic Factors | Population Document Number: 341911 |
| 28. Title: Instruments and supplies needed to provide clinical methods of family planning. Author: EngenderHealth Source: [New York, New York], EngenderHealth, [2008]. [2] p. Abstract: This is a checklist of the minimum number and types of medical instruments and supplies that EngenderHealth recommends as needed for provision of each of the four clinical methods of family planning (hormonal implants, IUDs, female sterilization, and vasectomy). Language: English Keywords: GLOBAL | MANUAL | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE AVAILABILITY | IUD | INJECTABLES | CONTRACEPTIVE IMPLANTS | VASECTOMY | FEMALE STERILIZATION | FAMILY PLANNING | OBSTETRICAL SURGERY | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Contraceptive Methods | Male Sterilization | Sterilization, Sexual | Surgery | Treatment Document Number: 331564 |
| 29. Title: The ACQUIRE Project end of project report to USAID, October 1, 2003 - September 30, 2008. Author: EngenderHealth. ACQUIRE Project Source: New York, New York, EngenderHealth, ACQUIRE Project, 2008. [62] p. (USAID Cooperative Agreement No. GPO-A-00-03-00006-00) Abstract: The ACQUIRE Project -- Access, Quality, Use and Reproductive Health -- was USAID's flagship project for global leadership in FP / RH service delivery, funded from October 2003 to September 2008. EngenderHealth implemented and managed ACQUIRE in partnership with the Adventist Development and Relief Agency International (ADRA), CARE, IntraHealth International, Meridian Group International Inc., and the Society for Women and AIDS in Africa (SWAA). The Project's core mandate was to provide comprehensive programming support for FP / RH facility based services with an emphasis on long-acting and permanent family planning methods (LAPM): intrauterine devices (IUD), implants, female sterilization, and vasectomy. ACQUIRE provided global technical input and support to 22 countries to increase access to, improve the quality of and scale up RH / FP services that yielded impressive gains in LAPM family planning use. (Excerpts) Language: English Keywords: BANGLADESH | DEVELOPING COUNTRIES | SUMMARY REPORT | REPRODUCTIVE HEALTH | FAMILY PLANNING | HEALTH SERVICES | QUALITY OF HEALTH CARE | PERFORMANCE IMPROVEMENT | IUD | FEMALE STERILIZATION | CONTRACEPTIVE IMPLANTS | MALE STERILIZATION | DELIVERY OF HEALTH CARE | NEEDS | Asia, Southern | Asia | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Management | Contraceptive Methods | Contraception | Sterilization, Sexual | Economic Factors Document Number: 331465 |
| 30. Title: Improving provision of vasectomy. Author: Family Health International [FHI] Source: Research Triangle Park, North Carolina, FHI, 2008. [2] p. (FHI Briefs: Menu of PracticesUSAID Cooperative Agreement No. GPO-A-00-05-00022-0) Abstract: Vasectomy is an extremely safe and effective method of contraception. It is simpler, safer, less costly, and equally effective as female sterilization, and yet it remains the least-used contraceptive method worldwide. Despite commonly held assumptions about male attitudes or societal prohibitions, men in every region and cultural, religious, or socioeconomic setting have shown interest in vasectomy when seeking contraception. However, men often lack full access to information and services. Efforts to improve access to and use of vasectomy need to include creating demand and improving services. Increasing access to and uptake of vasectomy can help men and women achieve their reproductive intentions and fosters male involvement in family planning. Language: English Keywords: DEVELOPING COUNTRIES | RECOMMENDATIONS | MEN | COUNSELING | VASECTOMY | VAS OCCLUSION | HEALTH SERVICES | Demographic Factors | Population | Clinic Activities | Program Activities | Programs | Organization and Administration | Male Sterilization | Sterilization, Sexual | Family Planning | Delivery of Health Care | Health Document Number: 331525 |
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