Blockade of tubal patency following transcervical administration of polidocanol foam: Initial studies in rhesus macaques

Jeffrey T. Jensen, Carol Hanna, Shan Yao, Elizabeth Micks, Alison Edelman, Lindsay Holden, Ov D. Slayden

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objective To demonstrate the feasibility of polidocanol foam (PF) as a nonsurgical method of female permanent contraception using a nonhuman primate model. Study Design Four groups of adult female rhesus macaques underwent either transcervical treatment with 5% PF directly into the uterine cavity, treatment with inert (methylcellulose, MF) foam or no treatment followed by removal of the reproductive tract for histologic evaluation. Untreated animals were included in Group 1 (n= 3). Group 2 animals (n= 4) were treated once with MF. Group 3 (n= 7) received a single, and Group 4 (n= 5) received multiple monthly treatments with PF; in these 2 groups, baseline tubal patency was assessed either laparoscopically by chromopertubation (CP) or by hysterosalpingography. Results Group 1 (untreated) and Group 2 (MF) animals had normal tubal histology. In contrast, Group 3 and 4 females treated with PF showed evidence of tubal damage. In Group 4, bilateral tubal blockade was noted on CP after two (n= 2) or three (n= 3) treatments. Histologic analysis confirmed complete tubal occlusion (loss of epithelium, fibrosis) in three of these animals, and one showed significant tubal damage localized to the intramural segment. Nontarget (cervix, vagina, endometrium, ovary) reproductive tissues were unaffected. While similar tubal changes were observed after a single treatment (Group 3), endometrial hemorrhage was also noted as an acute change. Conclusion PF is a promising candidate agent for nonsurgical permanent female contraception. The histologic features of PF occlusion are confined to the intramural portion of the tube. Implications This study in rhesus macaques supports further development of transcervical administration of PF as a nonsurgical approach to permanent contraception. A nonsurgical method could reduce risks and costs associated with surgical female sterilization and increase access to permanent contraception.

Original languageEnglish (US)
Pages (from-to)540-549
Number of pages10
JournalContraception
Volume89
Issue number6
DOIs
StatePublished - Jun 2014

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Keywords

  • Female
  • Nonhuman primate
  • Nonsurgical
  • Sterilization
  • Tubal occlusion

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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