M. Harper
1982
Citations
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Influential Citations
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Citations
Quality indicators
Journal
Medicinal research reviews
Abstract
This review of fertility control focuses on recent prospects for fertility control, perspectives on fertility control drugs under investigation (established drugs and novel structure and biological activities), and future prospects for fertility control. Most of the research being conducted on new contraceptive devices is concentrated on 2 progestational steroids--norethisterone and its ester norethisterone enanthate, and levonorgestrel. Norethisterone is no longer under patent protection, and levonorgestrel, while still protected by patent, has been the benchmark as far as potent progestational steroids are concerned. Its potency allows the use of smaller daily quantities to be released to achieve the same biological action. This enables the life span of the device to be prolonged. In the IUD field, the devices being developed are able to release either copper progestational steroids. A new derivative of levonorgestrel, called desogestrel has recently been described and is reported to be twice as potent as levonorgestrel. If this proves to be the case, it might supplant levonorgestrel as the contraceptive steroid of choice for new device development. New developments are under way to produce both better and more acceptable barrier contraceptive methods. An area that has immediate promise for development of new contraceptive or fertility control methods is the development of nonsurgical methods for female sterilization. There are 3 candidate chemicals which seem to be effective and have been widely used clinically. The chemical used most extensively has been quinacrine, but it is known to have toxic properties. It has caused amenorrhea, intrauterine adhesions, chemical vaginitis, skin rash, and central nervous system excitation in women. There are 3 main classes of chemical compounds which fall into the general category of established drugs. For these drugs there are data from clinical studies which include both Phase 1 studies and efficacy studies. These agents, which can be classified into the groupings of steroids, prostaglandins, and analogs of luteinizing hormone releasing hormone (LRH, LHRH, LRF), are reviewed. It does appear that without some fresh impetus, such as the elucidation of certain physiological control processes, identification of the structure of native hormones like inhibin, and characterization of the structure of the progesterone receptor, further progress will be slow and limited.