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Clinical Trial
, 34 (4), 381-93

Longevity of Ortho Creme and Gynol II in the Contraceptive Diaphragm

Clinical Trial

Longevity of Ortho Creme and Gynol II in the Contraceptive Diaphragm

W S Leitch. Contraception.

Abstract

A literature review yielded no scientific basis for the currently accepted recommendations on the length of time spermicides used with diaphragms continue to kill sperm. Twelve volunteers provided 68 spermicide samples representing 6, 12, 18, and 24 hours of in vivo insertion in a contraceptive diaphragm using Ortho Creme, Gynol II, and vehicle controls. Testing for continued spermicidal effect was performed in the laboratory using quality semen from 2 donors and employing the Multiple Exposure Photography system of semen analysis. Results showed effective spermicidal action after 12 hours of insertion, mixed effectiveness after 18 hours, and poor effectiveness after 24 hours with both products, with Ortho Creme being more effective in the longer insertions. Placebo jelly enhanced sperm activity while placebo creme had a moderate inhibitory effect. Recommendations for further study are made.

PIP: A literature review yielded no scientific basis for the currently accepted recommendations on the length of time spermicides used with diaphragms continue to kill sperm. In a study performed at the Yale School of Nursing, 12 volunteers provided 68 spermicide samples representing 6, 12, 18, and 24 hours of in vivo insertion in a contraceptive diaphragm using Ortho Creme, Gynol II, and vehicle controls. Testing for continued spermicidal effect was performed in a laboratory using quality semen from 2 donors and employing the Multiple Exposure Photography system of semen analysis. Results showed spermicidal action after 12 hours of insertion, mixed effectiveness after 18 hours, and poor effectiveness after 24 hours with both products, with Ortho Creme being more effective in the longer insertions. Placebo jelly enhanced sperm activity while placebo creme had a moderate inhibitory effect. Guidelines developed from this study suggest that insertion of a diaphragm for up to 12 hours before intercourse is permissible using jelly or creme spermicides. Cream may be effective for even longer insertions, although a greater than 24 hour total insertion time is not recommended. This upper limite recommendation is indicated by studies in the literature warning of Toxic Shock Syndrome. Since majority of diaphragm failures are attributed to non-compliance or non-use, it is only reasonable that efforts be made to make the methods as easy to use as is safely possible. Many other areas of diaphragm use need to be reappraised with this in mind.

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