title: Quinacrine sterilization (QS): time for reconsideration.
abstract: Dr. Jaime Zipper, the Chilean inventor of the quinacrine method of nonsurgical permanent contraception, was aware that when chest surgeons injected quinacrine into the pleural cavity to treat and prevent reoccurrence of pleural effusion, it resulted in the formation of fibrous adhesions between the lung and costal pleura. Zipper thought that a similar scarring effect could occur in the fallopian tubes if quinacrine was instilled into the uterine cavity. A series of refinements of the methodology culminated in the use of a modified Copper T intrauterine device inserter tube as a delivery system to introduce seven quinacrine pellets into the uterus. This approach with quinacrine sterilization (QS) was introduced into clinical practice in several countries, and a national clinical trial of over 50,000 women was conducted in Vietnam. However, in 1993, the World Health Organization raised concerns that quinacrine might be carcinogenic. This resulted in abandonment of QS in Vietnam and other countries. Subsequent epidemiologic data from extensive human studies do not support an increase in cancer risk. This paper reviews the history, limitations and clinical potential of QS.
authors.affiliation: State University of New York at Buffalo, School of Medicine, 31 Hampton Hill Drive, Buffalo, NY 14221. Electronic address: jacklippes90@gmail.com.
authors.forename: Jack
authors.initials: J
authors.lastname: Lippes
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D000818:Animals; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004343:Drug Implants; D004717:Endometrium / Q000187:drug effects; D005187:Fallopian Tubes / Q000187:drug effects*; D005193:Family Planning Services / Q000266:history*; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000009:adverse effects; D011796:Quinacrine / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D013246:Sterilization, Tubal / Q000009:adverse effects / Q000266:history*
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants; D011796:Quinacrine
keywords: Epidemiology; Nonsurgical; Permanent contraception; Quinacrine