The intrauterine instillation of quinacrine seems to represent a simple, inexpensive, effective and safe method of non-surgicical female sterilization. Why then, it is not in widespread use, years after considerable field experience has been gained?
The problem is that existing toxicology for topical use of quinacrine pellets is incomplete. This promted, in the summer of 1994, an expert group convened by WHO, to comment that the toxicology of locally applied quinacrine completed more than a decade ago is inadequate.To counter this statement the proponents of the method argue that it is unfair to apply the same stringent pre-clinical requirements that are mandatory in the industrialized world, also to methods utilized in developing countries which are plagued by both high fertility and high maternal mortality?
The WHO however, has so far, declined to apply two standards - one, strict, for developed countries and another one, less stringent, for developing countries, and - unfortunately - in recent studies quinacrine was shown to be positive in three of the four mutagenicity tests. Because there is no direct evidence of carcinogenicity in humans, it is difficult to extrapolate mutagenicity data to humans.
Under the circumstances, is there hope for the use of quinacrine for non-surgical female sterilization? Much will depend on how the situation will evolve in the near future in terms of results from long-term animal studies and retrospective human studies.
Learning Objectives: After the session, the learner will understand concerns about the safety of quinacrine sterilization
Keywords: Contraception, Cancer Prevention
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.