Current status of fertility control methods in India |
| |
Authors: | R S Sharma M Rajalakshmi D Antony Jeyaraj |
| |
Institution: | (1) Indian Council of Medical Research, Ansari Nagar, 110 029 New Delhi, India;(2) National Academy of Medical Sciences, 110 029 New Delhi, India;(3) Department of Cell Biology and Anatomy, University of North Carolina at Chapel Hill, CB 7090, 27599 Chapel Hill, NC, USA |
| |
Abstract: | Approximately 48.2% of couples of 15 to 49 years of age practice family planning methods in India. Female sterilization accounts
for 34.2%, with male sterilization declining from 3·4% in 1992–93 to 1·9% in 1998–99. Use of the condom increased to 3·1%
from 2·4%. There is an urgent need for research to develop new contraceptive modalities especially for men and also for women
and to make existing methods more safe, affordable and acceptable. Current efforts in India to develop a male contraceptive
are mainly directed towards (i) development of antispermatogenic agents to suppress sperm production, (ii) prevention of sperm
maturation, (iii) prevention of sperm transport through vas deferens or rendering these sperm infertile and (iv) prevention
of sperm deposition. Research work in the field of prevention of sperm transport through vas deferens has made significant
advances. Styrene maleic anhydride (SMA) disturbed the electrical charge of spermatozoa leading to acrosome rupture and consequent
loss in fertilizing ability of sperm. A multicentre phase-III clinical trial using SMA is continuing and it is hoped that
the SMA approach would be available in the near future as an indigenously developed injectable intra-vasal male contraceptive.
The safety and efficacy of available oral contraceptives were evaluated. An indigenously developed oral contraceptive ‘Centchorman’,
which is a nonsteroidal, weakly estrogenic but potently antiestrogenic, was found to be safe and effective and is now being
marketed in India since 1991 as a ‘once a week’ pill. Cyclofem and Mesigyna have been recommended as injectable contraceptives
with proper counselling and service delivery by Indian studies. It has been recommended that these injectable contraceptives
be added to the existing range of contraceptive methods available in the National Family Planning Programme. Based on the
Indian studies CuT 200 was also recommended. Studies have indicated the advantage of intrauterine devices (IUD); they are
long acting, relatively easily removed and fertility returns rapidly after their removal. Recent studies have recommended
CuT 200 for use up to 5 years. The combination of some plant products i.e.Embelia ribes, Borax andPiper longum has been found to be safe and effective as a female contraceptive and the results of phase-I clinical trials are encouraging.
Research work is going on in the country in various areas with special reference to hormonal contraceptive — a three monthly
injectable contraceptive, immuno-contraceptives, antiprogestins, etc. |
| |
Keywords: | Epididymis estrogen luteinizing hormone ovary progesterone sperm testis testosterone uterus |
本文献已被 SpringerLink 等数据库收录! |
|