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Association for Voluntary Sterilization - Consultant Team. Trip report: the People's Republic of China, Beijing, Chongqing, Wuhan, Guangzhou, June 19-30, 1985.
[Unpublished] 1985. 41,  p.The Association for Voluntary Sterilization consultant team visited Beijing, Chongqing, Wuhan and Guangzhou, China in June 1985, to review innovative nonsurgical methods of male and female sterilization. There are 2 variations on vasectomy, performed with special clamps that obviate a surgical incision. The 1st is a circular clamp for grasping the vas through the skin, and the 2nd is a small, curved, sharp hemostat for puncturing the skin and the vas sheath, used for ligation. Vas occlusion with 0.02 ml of a solution of phenol and cyanoacrylate has been performed on 500,000 men since 1972. The procedure is done under local anesthesia, and is controlled by injecting red and blue dye on contralateral sides. If urine is not brown, vasectomy by ligature is performed. The wound is closed with gauze only. Semen analysis is not done, but patients are advised to use contraception for the 1st 10 ejaculations. Pregnancy rates after vasectomy by percutaneous injection were reported as 0 in 5 groups of several hundred men each, 11.4% in 1 group and 2.4% in another group. The total complication rate after vasectomy by clamping was 1.8% in 121,000 men. 422 medical school graduates with surgical training have been certified in this vasectomy method. Chinese men are pleased with this method because it avoids surgery by knife, and asepsis, anesthesia and counseling are excellent. Female sterilization by blind transcervical delivery of a phenol-quinacrine mixture has been done on 200,000 women since 1970 by research teams in Guangzhou and Shanghai. A metal cannula is inserted into the tubal opening, tested for position by an injection of saline, and 0.1-0.12 ml of sclerosing solution is instilled. Correct placement is verified by x-ray, an IUD is inserted, and after 3 months a repeat hysteroscopy is done to test uterine pressure. Pregnancy rates have been 1-2.5%, generally in the 1st 2 years. Although this technique is tedious, requiring great skill and patient cooperation, it can be mastered by paramedicals. The WHO is assisting the Chinese on setting up large studies on safety and effectiveness, as well as toxicology studies needed, to export the methods to other countries.
In: Family planning and contraceptive needs in developing countries: a report of a symposium held on October 23, 1985 at Organon International B.V., Oss., The Netherlands, edited by Jackie Bailey. Apeldoorn, Netherlands, Dept. of Organon International B.V., Institutional and Family Planning Affairs, 1985. 29-37.The 1984 International Population Conference in Mexico City acknowledged that fertility regulation is far from optimal. Recommendations 69, 70, 71 and 72 stress the need to increase and strengthen research into various aspects of human reproduction and fertility regulation--biomedical, epidemiological, service, and operations research. This article focuses on the contraceptive methods available: combined oral contraceptives, injectable, and implantable progestogen-only steroidal contraceptives (Depo Provera, norethisterone enanthate, and Norplant), IUDs, surgical sterilization, and barrier methods, and the medical side effects of each. In addition, 4 promising methods under development are reviewed. 1) The use of antiprogestogens to prevent/intercept pregnancy; 2) vaginal rings; 3) vaccines for men and women; and 4) modern methods for men--the highest risk area of all 4 because so much basic research needs to be done. The new methods called for by the Population Conference can be produced although there are major contraints to progress: 1) inadequate finalcial resources; 2) product and research liability; 3) sometimes excessive and seemingly irrational requirements of national drug authorities; and 4) social and political considerations.
Bulletin of the World Health Organization. 1978; 56(3):343-52.The WHO Special Programme of Research, Development and Research Training in Human Reproduction has established a 6-center program to investigate new fertility regulating agents from plants for use in humans. Establishment of the project was preceded by a comprehensive search of the literature, including the following sources: 1) articles on medical botany; 2) reports of testing crude plant extracts for fertility regulating purposes; 3) reports of in vitro effects of plant extracts; and 4) reports of a limited number of experimental studies in human subjects. The limitations of these sources of data are discussed. Information on 3000 plants was collected and computerized, using a weighting system, in order to assign priorities on the plant substances most promising for further study. The 6 centers will then procede to initiate pharmacological and chemical studies on the priority substances. Both male and female antifertility agents are included in the study. (Summary in FRE)
SCIENCE. 1980 Aug 29; 209(4460):992-4.WHO (World Health Organization) has sponsored a multinational cooperative research project in drug chemical synthesis outside the established pharmaceutical company channels. It is a model of particular relevance to developing countries and 1 that could be followed for development of drugs and pesticides. This particular program was launched because the pharmaceutical companies in developed countries were not interested in developing contraceptives that would be applicable for developing areas. The WHO-sponsored program involved synthesis of novel steroid compounds and thorough biological evaluation of the new substances. Approximately 220 steroids were synthesized in 12 laboratories in both developed and developing countries. The administrative and supervisory system of the program is explained. Quality control of the synthesized compounds took place at City University, London, and bioassay at the National Institute of Child health and Human Development in Bethesda, Maryland. The bioassay to determine the duration of long-acting progestogens was the suppression of estrus in rats. The test for androgenic activity was carried out in castrated male rats. Work on potential male contraceptives is being discontinued for financial reasons. However, 6 compounds of possible use in female contraception have been selected for further work.
American Pharmacy. 1979 Sep; 19(10):23-4.Pharmaceutical scientists and botanists from all over the world met at the University of Illinois to map a 3-year program for collecting and testing plants which may be effective in regulating fertility. Launched in July, 1979, the project will continue through May, 1982. The study is sponsored by the World Health Organization. More than 100 pounds of each plant sample are needed for the pharmacological and phytochemical tests. 300 plant species will be studied, which represents only a fraction of the almost 4000 species for which fertility-regulating information has been gathered. In 1974 Americans paid about $3 billion for prescriptions of plant-extracted drugs. In the same year the pharmaceutical companies devoted only $200,000 of a $1 million research effort to the study of plant extracts. The plant data are being analyzed and stored with the help of a computer system developed at the Illinois College of Pharmacy. The Natural Products Alert (NAPRALERT) system considers whether or not a plant is poisonous or has adverse side effects. An estimated 5000 scientific periodicals are computerized per year. Some 4000 plants are listed, but another 4000 with fertility regulation potential are expected to be recorded. Some 750,000 species of flowering plants grow on earth.
Evaluation of the work of the Task Force on Indigenous Plants for Fertility Regulation of the Special Programme of Research in Human Reproduction.
In: Assessment of the WHO Special Programme of Research, Development and Research Training in Human Reproduction [HRP]. II. Task Force reports. Country reports, [compiled by] Sweden. Swedish Agency for Research Cooperation with Developing Countries [SAREC]. Stockholm, Sweden, SAREC, 1983 Apr.  p..This report describes and evaluates the work of the Task Force on Indigenous Plants for Fertility Regulation of the Special Programme of Research in Human Reproduction at WHO. The goal of the project is to set up a network of collaborating centers to train personnel, design bioassays, isolate and test plant substances that are safe and effective by oral route for "morning after" pills or anti-implantation agents or male contraceptives. Plants chosen for assay were selected by a literature search including ethnomedical sources. All data were computerized, weighted and rank ordered. 300 of the 4500 species fell into the high priority group. 4 research centers now participate: Chinese University of Hong Kong, Seoul National University, University of Peradeniya, Sri Lanka and University of Illinois. In 1980-1981 the literature surveillance component of the Task Force provided bi-annual literature updates on the assigned plants. Primate studies are planned for 1982 and phase I human trials are anticipated in 1985 for the 1st compound. Zoapatle (Montanoa tomentosa) is a plant used for centuries in Mexico to terminate early pregnancy. An active compound, zoapatanol, and another more stable analogue are in pre-phase I trials. 4 plants from India are being examined for sperm agglutination activity, the spermatogenesis inhibiting effect of Koenchai (Chinese celery) and the mechanism of action of gossypol are being researched.