Needs for New Fertility Control Technology

Abstract

Although other factors influence the fertility patterns the nature of available fertility control technology appears to be a foremost determinant. The best examples of this impact have occurred in developed countries. In the U.S. oral contraceptives plus IUDs have resulted in large increases in use of contraception. When abortions were made available in Eastern Europe and Japan a rapid decline in fertility resulted; restrictions of abortions in Romania resulted in a tripling of the birth rate. In less developed countries technics need to be suited to local conditions. Health and nutrition considerations may cause problems with methods. Increased bleeding with IUDs is serious when anemia from parasitic infection is already present. Decreased lactation among some users of oral contraceptives may compromise infant nutrition. The Agency for International Development (AID) has chosen to focus most of its funding on: a) control of fertility by regulation of corpus luteum function; b) studies of antiprogestins; c) gonadotropin releasing factors; and d) prostaglandin research. Prostaglandin research has developed compounds and their analogs that appear to be most promising though in need of improvement. Research to improve current methods is emphasized as is improvement in methods of surgical termination of pregnancy where medical care and personnel are deficient (including better tests to determine pregnancy and suction apparatus for use where there is no electric power). Improved sterilization methods are also needed. Injections and once-a-month contraceptives are also under study. Analogs to the natural prostaglandins new small bore cannulae for suction curettage and improved female sterilization techniques will soon be available for family planning programs.