No abstract

In the past decade, involuntary childlessness has become a major problem in many areas of the world. At the same time evidence confirms a link between sexually transmitted diseases (STDs) and the burgeoning infertility problem. STDs can adversely affect fertility by three primary mechanisms: (1) pregnancy wastage; (2) neonatal deaths; and (3) obstruction of either male or female reproductive ducts. STD control programs have been effective in preventing sequelae of disease, including infertility. The first step in developing such a program is to identify the magnitude and distribution of the problem, and to identify the specific agents most commonly involved. Subsequently, an STD control program emphasizing the prevention of infertility, can be incorporated into the existing health care system whenever STDs are an important cause of infertility.

No abstract

Except for data from several geographically limited studies, little is known globally about the number and causes of death associated with surgical sterilization. To identify clinical characteristics and problems leading to deaths related to the procedures, the International Planned Parenthood Federation ( IPPF ) and the Centers for Disease Control (CDC) in the United States collaborated in a global mail survey of 4642 physicians. Usable responses were received from 1298 physicians (28%) in 80 countries. Fifty-five sterilization-associated deaths which occurred from January 1, 1980 to June 30, 1982 were reported. The most frequently reported causes of death were infection, anesthetic complications, and hemorrhage. There were some regional differences in the relative frequencies of these causes. Most cases did not involve surgical accident. The characteristics most frequently associated with the reported fatal procedures were: interval sterilizations, minilaparotomy incision, tubal ligation and general anesthesia. Most deaths were attributable to the surgical sterilization procedure.