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Quinacrine sterilization (QS) in Iran and the use of HSG as a measure of success
Author(s) -
SoroodiMoghaddam S.
Publication year - 2003
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(03)90096-8
Subject(s) - medicine , sterilization (economics) , family planning , pregnancy , obstetrics , female sterilization , surgery , gynecology , population , research methodology , genetics , environmental health , biology , monetary economics , economics , foreign exchange market , foreign exchange
Objectives: To establish the safety, effectiveness and acceptability of quinacrine sterilization (QS) in Iran. To determine whether the hysterosalpingogram (HSG) performed under low pressure can be used to demonstrate success of the QS procedure rather than waiting for a pregnancy to occur in order to demonstrate failure. Methods: This study was initiated in September 1990 in a private family planning clinic in Tehran, Iran. Patient intake for this analysis was completed 31 December 1998 and the cut‐off date for follow‐up data to be included in this analysis was 30 July 2002. During this period, 268 women received QS. From inception until April 1994, 160 women entered the study. The first 62 women received 3 insertions and the remainder received 2. Short‐term side effects were closely followed in these 160 women. From 18 February 1994 until the patient intake cut‐off date, 131 women entered the study and 46 of them received an HSG. Results: With 4 to 12 years of follow‐up there have been 7 pregnancies for a gross pregnancy rate of 2.6%. However, the use of the HSG tripled the risk of pregnancy for women who underwent the procedure. Furthermore, HSG, even when performed under minimal pressure, indicated failure of the QS procedure about 6% of the time when in fact both tubes would have closed had there been no intervention. Side effects were minor when compared to the complications of surgical sterilization. Conclusions: QS was found to be safe, effective and preferred over surgical sterilization by Iranian women. HSG understated the number of patients with bilateral tubal closure, or with tubes that would have closed given a little more time.