Long-term follow-up after quinacrine sterilization in Vietnam. Part I: interim efficacy analysis

Objective: To determine the long-term efficacy of nonsurgical sterilization with quinacrine. Design: Observational cohort study. Setting: Rural provinces in northern Vietnam. Patient(s): Two thousand seven hundred and nine women who had quinacrine in sertions between 1989 and 1993. Intervention(s): Interviews in 1994, 1995, and 1996 and review of available medical records. Pregnancy rates were corrected for problems in detecting and confirming pregnancies. Main Outcome Measure(s): Pregnancy rates. Result(s): Over 90% of women were interviewed at least once. Uncorrected cu mulative pregnancy rates were 12.9% at 5 y after two insertions and 27.3% a fter one insertion. Effectiveness varied by age group: the partially correc ted pregnancy rates after two insertions were 6.8% in women 35 or older at the time of insertion and 13.0% in women under 35. A subgroup of women who received oral papaverine at the time of quinacrine insertion had lower preg nancy rates, with a cumulative uncorrected rate of 5.3% at 4 years among wo men of all ages. Conclusion(s): Efficacy of quinacrine appears reasonable for two insertions of quinacrine in women 35 and older. It may be possible to improve efficac y by the use of papaverine or the Hieu insertion technique. (Fertil Steril( R) 2000;74:1084-91. (C) 2000 by American Society for Reproductive Medicine) .