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Lancet. 1985 May 4; 1(8436):1046.As part of a study on acute febrile pelvic inflammatory disease and IUDs, reported elsewhere, a significantly lower risk of PID was observed in women using injectable contraceptives. The World Health Organization coordinated the multinational case-control study in 1979-79. Diagnostic criteria were fever, suprapubic tenderness with guarding, cervical or adnexal tenderness or a pelvic mass. 319 cases and 639 matched controls were matched for age, parity, marital status and hospital status. Data were taken from questionnaires. 10 cases (3.1%) currently used injectable contraceptives, mainly Depo-Provera, compared to 38 controls (6.0%). Thus the risk of getting PID was half as great among injectable users, similar in magnitude to risks reported for women using oral contraceptives, barrier methods and sterilization in developing countries.
Geneva, WHO, 1982 Nov. 159 p.The World Health Organization's (WHO) 7th General Program of Work, covering the period 1984-89, includes the WHO Special Programme of Research, Development, and Research Training in Human Reproduction. Objectives of the latter include improving the health status of populations in developing countries by: 1) devising improved approaches to the delivery of family planning care in the primary health care context, 2) assessing the safety of existing methods of fertility regulation, 3) developing new contraceptive technology, and 4) generating the knowledge and technology required for the prevention and treatment of infertility. By 1989 the program aims to have devised the means of integrating family planning into primary health care, assessed the safety and efficacy of contraceptive methods used between 1970-77, and those introduced between 1977-85, developed at least 6 new methods of contraception, clarified the etiology of certain reproductive diseases, and strengthened at least 1 research facility in each of those developing countries that will have national policies on and services for family planning. Some findings of research included: 1) copper bearing IUDs with a minimum surface area of 200 mm are safe and effective for at least 4 years of use, 2) depot-medroxyprogesterone acetate (DMPA) has been shown to have no apparent adverse effect on the quantity of breast milk, and 3) mean delay of conception after DMPA use was 6 months for women 20-24 years, 6.2 months for women 25-29, and 8 months for women age 30 and over. Work has centered on developing new injectable contraceptives of 3 or more months' duration, biodegradable implants, and vaginal rings that release 20 mcg levonorgestrel/day for 3 months. Several non-isotopic techniques have been developed for predicting and detecting ovulation as well. Research on infertility has studied standardized investigation of infertile couples, prevalence in different populations, and etiology. Other areas of work have been in institution strengthening, dissemination of information, and relations with industry.