Trends in the use of female sterilisation through minilaparotomy for contraception at a teaching hospital in north central Nigeria.

BACKGROUND: Female sterilisation is the most widely used method of contraception worldwide. However, only a small proportion of contraceptors are reported to rely on female sterilisation in Nigeria. Continuous reviews of trends in its use are necessary to develop policies that will improve uptake in the country. OBJECTIVE: To determine the volume and trends in the use of female sterilisation through minilaparotomy as a method of contraception in a Nigerian university teaching hospital. METHODS: The records of women who had sterilisation through minilaparotomy over a ten year period were reviewed for socialdemographic characteristics, reasons for undergoing sterilisation, timing of the procedure, surgical method used and complications recorded. This is too sketchy RESULTS: Female sterilisation through minilaparotomy accounted for 95 (0.8%) of the 12,035 total contraceptive use during the period. The rate decreased from 1.5% of total contraceptive use in 1995 to 0.22% in 2003. Eighty two (86.4%) of the female sterilisation acceptors were aged 35 years and above, 46 (48.4%) had no or only primary education and 42 (44.2%) were petty traders. Sixty six (69.5%) of the women were grandmultiparae and 70 (73.7%) had more children than they desired. Seventy three (76.8%) had used other contraceptive methods before sterilisation. The average cost of female sterilisation through minilaparotomy in our hospital was USD25 and this was significantly more than the cost of other contraceptives, and more than hospital charges for normal vaginal delivery. CONCLUSION: The proportion of contraceptive acceptors who rely on female sterilisation is low in our environment and has steadily declined over the years. The higher cost of the procedure as compared to other contraceptives appears to be the main barrier. Reduction or outright elimination of cost will probably act as incentive for women to choose female sterilisation as a method of contraception.

Pulsatile release of FSH for superovulation in cattle.

The studies reported here were directed towards the development of an implantable microcapsule which "pulses" release of follicle stimulating hormone, FSH, for application to superovulating cows. Final dose forms were administered using membrane-coated cylinders. The "pulse" of the FSH is achieved by membrane encapsulation of an effervescent/swelling core containing citric acid, sodium bicarbonate, glucose and FSH. Entry of water results in sufficient pressure increase (by gas generation) to rupture ("burst") the membrane. Time to rupture is dependent upon several factors, such as membrane permeability and thickness, and core composition and loading. The final dose forms were implanted by means of a trochar. This system was tested in sheep to substantiate in vivo "burst" times and then tested in cows to determine efficacy. In vivo burst times in sheep varied from 8 to 96 hr, based upon maximal FSH values in blood serum, and generally paralled the planned times resulting from in vitro tests. Multiple capsules designed to release FSH as a pulse or steady state were tested on a limited number of cows plus a control (n = 10). Four of the combinations resulted in 11, 11, 14 and 16 ovulations, indicating that further development has promise of providing a one-injection system using FSH for superovulating cattle.