Potential demand for voluntary female sterilization in the 1980s: the compelling need for a nonsurgical method.

The authors estimate the potential world demand for voluntary sterilization on the basis of U.S. data which shows that 31.3% of U.S. married women of reproductive age are sterilized. If sterilization were equally available elsewhere, they estimate that approximately 180 million procedures would be required during the 1980s, or a five-fold increase over the number now being performed. Of presently available methods colpotomy, culdoscopy, the tantalum clip, and hysteroscopy are not satisfactory. In the author's view, minilaparotomy is the safest procedure, especially when performed by less specialized junior physicians and in rural areas. The most promising new methods use chemicals instilled into the fallopian tubes. Quinacrine pellets inserted through an IUD inserter have an estimated lifetime failure rate of 3/100 women. The authors consider this a safe approach costing about 1/2 as much as surgical sterilization. The quinacrine method has the potential to meet estimated developing country needs and also to be widely used in developed countries. They urge priority for further research on this method.