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    Effectiveness of vaginal foam ovula: controversies in West Germany.


    Presented at the Program for Applied Research on Fertility Regulation and Asociacion Pro-bienestar de la Familia de Guatemala International Workshop on New Developments in Vaginal Contraception, Guatemala City, Guatemala, April 25-27, 1979. 15 p

    The effectiveness and promotional claims of a particularly influential spermicidal suppository with purported foaming action (Encare Oval) were refuted and challenged. The results of a West German survey showed that amount of information on contraception and method used were closely related; unfortunately, then, adolescents being less informed, choose spermicidal over-the-counter agents, and 60-70% choose Encare Oval. Encare contains nonoxynol, a surface active substance which exerts spermicidal activity by lowering the tension of the sperm cell surface leading to loss of motility because of osmotic imbalance. The manufacturer claims that following deep intravaginal application, Encare melts at body temperature and creats a so-called "barrier function." It is claimed that this foam from the suppository distributes the spermicide more effectively. Since few studies (none prospective) have addressed these claims, Pro Familia centers were solicited for retrospective data on usage and contraceptive failure of Encare. Related to the computed number of all counseled visitors, i.e., including nonpregnant women 3eeking advice, and provided a 15% overall Encare user rate in the general fertile female population, the number of pregnancies occurring under Encare (marked as PO in W. Germany) use was calculated in a range from 12.5-19.1%, meaning that every 6th-8th woman using the product will conceive; this rate is 5-6 times higher than with oral contraceptives and the manufacturer claims that the product is as safe and reliable as the pill. In addition, failures due to improper insertion were high; but of equal importance was the fact that the foaming action claimed was proven nonexistant 15 minutes after application.
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