U.S. rule highlights Catholic tensions over contraception

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Doctors explore the latest advances in contraception

MORNING-AFTER PILL’CDC report: More teen girls use best birth controlBirth control method gainsResearchers at the University of Edinburgh say they’ve found a gene that plays a key role in male fertility, suggesting it could be exploited to develop hormone-free birth control for men.

Until that happens, though, the responsibility for contraception seems likely to remain primarily with women. (A recent University of North Carolina survey, for example, polled 326 female students between the ages of 18 and 45. More than 89 percent said contraceptive responsibility should be shared, but just 51 percent said it actually was in their relationships.)

The search for better, more effective methods of birth control never ends. Tweaking the gene that helps make sperm viable is one of the newer approaches, but older methods (beyond the pill) are constantly revised to improve their safety and efficacy

We asked Dr. Sheila Mody, a contraceptive specialist in the University of California San Diego School of Medicine’s Department of Reproductive Medicine, to review the latest developments.

Q: There has been considerable media coverage recently of newer contraceptive methods, such as hysteroscopic sterilization (Essure), contraceptive implants (Implanon) and the intrauterine device (IUD). Can you explain how these contraceptives work and relative advantages?

A: Essure is a no-incision permanent sterilization method. A small camera is used to go through the vagina and the cervix to visualize the openings of the fallopian tubes in the uterus. Then very small nickel coils are placed in the tubes, which causes scar tissue to form and block them. The scarring process takes three months. This is an outpatient procedure and avoids general anesthesia. It is highly effective with a failure rate comparable to other sterilization methods.

Implanon is a contraceptive implant containing a hormone called progestin. It’s placed under the skin in the upper arm. An Implanon insertion can be done in a clinic and the implant works for up to three years. It’s very effective and completely reversible.

The IUD is a contraceptive method that is becoming increasingly popular. It is a small T-shaped device that’s placed in the uterus. An IUD placement can be done in the clinic. The IUD works up to five or 10 years, depending on the type. Women who have not had children are still eligible to use this method. It does not impact future fertility. It’s a nice alternative to birth control pills because you don’t have to remember to take a pill every day. One type of IUD

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Long-term contraception more effective than pills

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Long-term contraception more effective: study

"Women who choose birth control pills, the patch or vaginal ring are 20 times more likely to have an unplanned pregnancy than those using long-term methods such as IUDs and implants, a study found. (AFP Photo/Loic Venance)" title

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Long-term contraception more effective: study

"Women who choose birth control pills, the patch or vaginal ring are 20 times more likely to have an unplanned pregnancy than those using long-term methods such as IUDs and implants, a study found. (AFP Photo/Loic Venance)" title

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