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一项针对加拿大女性的非激素阴道凝胶隐形避孕套杀精/避孕效果的III期前疗效试验。

A Pre-Phase III Efficacy Trial of the Spermicide/Contraceptive Effect of the Invisible Condom, a Non-Hormonal Vaginal Gel, in Women from Canada.

作者信息

Omar Rabeea F, Leboeuf Mathieu, Lemyre Madeleine, Chabot Isabelle, Trottier Sylvie, Ulmann André, Bergeron Michel G

机构信息

Centre de Recherche en Infectiologie de l'Universite Laval, CHU de Québec-Université Laval, CHUL Hospital, Québec City, QC.

Department of Obstetrics and Gynaecology, Faculty of Medicine, Université Laval, Québec City, QC; Department of Obstetrics and Gynaecology, CHU de Québec-Université Laval, CHUL Hospital, Québec City, QC.

出版信息

J Obstet Gynaecol Can. 2022 Feb;44(2):175-181. doi: 10.1016/j.jogc.2021.09.018. Epub 2021 Oct 14.

Abstract

OBJECTIVES

To evaluate the spermicidal efficacy of non-hormonal vaginal gel in vitro and in a post-coital test, and to evaluate its contraceptive efficacy in Canadian women of childbearing age.

METHODS

We conducted single-centre trial to assess spermicidal and contraceptive efficacy of vaginal gel. Participants were healthy, sexually active women aged 18-49 years and their regular male sexual partners (30 couples). Measured outcomes included effect of vaginal gel on sperm motility in vitro, its effect on sperm in a post-coital test, and its effect on pregnancy prevention over 3 months.

RESULTS

For in vitro spermicidal effect, 98% and 67% of sperm were immotile in the presence of the gel with sodium lauryl sulfate (gel-SLS) and gel alone, respectively. For the post-coital test, 99% and 93% of sperm were immotile in the presence of gel-SLS and gel alone, respectively. In the second part of trial, a total of 410 instances of vaginal intercourse in 95 menstrual cycles were protected (during 3-month period of gel-SLS use before each sexual intercourse with probability of 24 conceptions prevented according to Wilcox's table). Four women became pregnant during the study period; 2 during unprotected vaginal intercourse around the time of ovulation, and 2 attributed to user failure.

CONCLUSION

Based on our results, the vaginal gel demonstrated important spermicidal and contraceptive effect. A larger phase III contraceptive efficacy trial is warranted. The vaginal gel may represent a non-hormonal spermicide/contraceptive option for women.

摘要

目的

评估非激素阴道凝胶在体外及性交后试验中的杀精效果,并评估其在加拿大育龄女性中的避孕效果。

方法

我们进行了一项单中心试验,以评估阴道凝胶的杀精和避孕效果。参与者为年龄在18至49岁之间的健康、有性生活的女性及其固定男性性伴侣(30对夫妇)。测量的结果包括阴道凝胶对体外精子活力的影响、其在性交后试验中对精子的影响以及其在3个月内对预防妊娠的影响。

结果

对于体外杀精效果,在含有月桂醇硫酸酯钠的凝胶(凝胶-SLS)和单独凝胶存在的情况下,分别有98%和67%的精子失去活力。对于性交后试验,在凝胶-SLS和单独凝胶存在的情况下,分别有99%和93%的精子失去活力。在试验的第二部分,在95个月经周期中共进行了410次阴道性交得到了保护(在每次性交前使用凝胶-SLS的3个月期间,根据威尔科克斯表预计可预防24次受孕)。在研究期间有4名女性怀孕;2名在排卵前后无保护的阴道性交期间怀孕,2名归因于使用者失误。

结论

根据我们的结果,阴道凝胶显示出重要的杀精和避孕效果。有必要进行更大规模的III期避孕效果试验。阴道凝胶可能为女性提供一种非激素的杀精剂/避孕选择。

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