OBJECTIVE: To develop a model to evaluate candidate agents to create tubal occlusion for nonsurgical permanent contraception DESIGN: Descriptive nonhuman primate study. MATERIALS AND METHODS: Reproductive tracts were collected from rhesus macaques (n¼10) at necropsy. Tubal patency was assessed by passing a small balloon catheter transcervically into the uterine cavity, and infusing foam until it was observed to pass freely from the ?mbriae end of the fallopian tubes. The specimens were infused with 5% polidocanol foam (PF), 3% PF, or methylcellulose (control) foam (10mL). Following the foam infusion, the specimen was incubated at 37C in a humidity chamber for 15 min, and then a solution of 8ml of 4% paraformaldehyde was delivered through the same catheter to rinse out the tube. The tract was then dissected to the cornua, isthmic, ampulla, and ?mbriae portions and then embedded in paraf?n, sectioned, and stained with hematoxylin and eosin for histologic evaluation. RESULTS: Controls treated with inert methylcellulose foam displayed normal tubal epithelium. In contrast, treatment with PF led to varying degrees of epithelial cell damage progressing in severity from patchy epithelial disruption to complete epithelial exfoliation, and lumen dilation con?ned to the intramural zone. Mucosal damage after 5% PF was more marked and consistent than the effect of 3% PF. CONCLUSIONS: Transcervical perfusion of the reproductive tract PF results in acute epithelial damage to the fallopian tubes. Previous studies report that PF treatment results in permanent tubal occlusion. Effects of PF reported here represent the initial events in this process. These results support the use of ex vivo experiments to evaluate novel sclerosing agents prior to nonhuman primate in vivo experiments.
Proceedings of the American Society for Reproductive Medicine 2016 Scientific Congress & Expo (ASRM'16), Salt Lake City, Utah (US), pp. e113