Antifertility Effects of an Intracervical Progestational Device

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Abstract
Chlormadinone acetate impregnated silastic devices placed in the cervix of rabbits interfered with fertilization, implantation and sperm transport. At a release rate of 13.7-22.8 µg/ kg/day the devices were 100% contraceptive, while at a dose between 2.4 and 7.0 µg/kg/day there was no interference with fertilization. At an intermediate dose (8.2-13.3 µg/kg/day) 47% of recovered ova were fertilized. There was no evidence of accelerated egg transport even with the highest release rates. Implantation was inhibited at doses insufficient to prevent fertilization. Sperm recovery performed 4 h after double-mating showed a statistically significant decrease in sperm number in horns containing a cervical device. Preliminary experiments in women with three types of chlormadinone acetate-releasing devices showed effects on cervical mucus when the estimated release rate was 0.15 mg/day. With a release rate of approximately 1.6-2.1 mg/day there were, in addition, systemic effects including elevation of basal body temperature, progestational changes in the endometrium and uterine bleeding.

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