Reversal of Sterilization due to Application of Quinacrine by Means of Transcervical Tubal Catheterization

Abstract

The cornual and intramural scarring associated with quinacrine-induced female sterilization has been presumed to make this method irreversible. However, this article presents the cases of two women from Calcutta, India, with successful reversal achieved through transcervical catheterization with recanalization under fluoroscopic guidance. The first woman, age 28 years, had been sterilized five years earlier by three treatments with 252 mg of quinacrine; the second, age 22 years, had been sterilized two years before reversal request with two quinacrine doses. Recanalization of the proximal right tube was achieved in both cases through use of two or three catheterization systems in sequential order; attempts to repair the left tube resulted only in venous intravasation. The gritty sensation during guide-wire recanalization was consistent with fibrosis in the intramural portion of the fallopian tube. The availability of this technique may increase the acceptability of quinacrine sterilization, especially in countries such as Egypt and Indonesia where national family planning programs require that sterilization techniques are reversible.