Index



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--> Index A Abortion, 5, 30, 48, 87-88, 219 maternal deaths from, 5, 72-74 rates of, 5, 65, 69, 70, 71-72, 73, 75-76, 77 reporting of, 92-93n unsafe and illegal, 5, 71-74, 87 worldwide, 68, 71-75, 77 Abstinence, 31, 80, 93n. See also Periodic abstinence Acidic buffers, 443 Acrosin, 153, 432-433 Acrosome development, 145, 390-391 Acrosome reaction induction, 433 inhibition of, 13, 147, 344, 420-421 premature, 14, 146-147, 148-149, 345, 396-397 Activin, 353 Adhesion molecules, 135, 138, 367, 373-374 Africa, 65, 68, 76, 83, 167, 172, 174, 194, 195, 214, 224 Agency for International Development (USAID), 19, 114, 212, 235n, 238, 278-279, 288, 290 American Caduceus Industries, 237 American Home Products Corporation, 259, 274, 293n, 320 Anti-androgens, 148 Antiestrogens, 13, 344, 364 Anti-implantation methods, 15, 137-139, 343, 364-368 Antiprogestins, 35, 117-118, 124n, 134, 139, 269, 270 controversy over, 14-15, 118, 272 as menses-inducers, 13, 117-118, 140, 141, 344, 364, 373 see also Mifepristone Apoptosis, 131, 133, 354-356, 361 Asia, 65, 68, 76, 167, 172, 194, 195, 215, 251 Avanti condom, 106, 240 Azoospermia, 120, 381, 382, 385 B Bacterial infections, 45n , 79, 81, 93n, 433, 434. See also Chancroid; Chlamydia; Gonorrhea; Syphilis Barrier methods, 13, 98, 105-106, 179, 344, 496 chemical, 105, 115-117, 431 mechanical, 105-106, 114-115, 431

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-->   protection against infections, 81, 98, 114-116, 179, 430-432 research and development, 10, 12, 13, 114-117, 343, 430-444 see also Cervical cap; Condoms; Diaphragms; Microbicides; Spermicides Basal body temperature (BBT), 108, 267 Basic science and research, 9, 10-12, 19, 125-130, 342-343, 345, 346 on barrier methods, 10, 12, 13, 343, 430-444 on female methods, 10, 13, 344, 351-374 on immunocontraception, 12-13, 14, 343, 401-425 on male methods, 10, 14, 345, 381-399 on monthly methods and menses-inducers, 10, 13, 14-15, 134-135, 139 -141, 343, 344, 373 "woman-centered agenda" in, 10, 19, 32-33, 342, 346 Beagle tests, 297, 339n Bellagio Conference, 38-39 Biodegradable formulations, 113, 271, 459 Biological science, 11, 125-130, 343 "Biologic sexism," 80 Biomaterials suppliers, liability, 21, 311, 317-318 Biotechnology industry, 240-244, 245, 248-253 globalization of market, 250-251, 253 noncontraceptive research and development, 274-277 Blastocyst implantation, 13, 135-136, 137, 165n, 340, 344, 361-362, 366, 499. see also Anti-implantation methods Boston Women's Health Book Collective, 299 Buffer gels, 115-116 Burroughs Wellcome Fund, 284, 287 C Cairo conference, 32, 40-41 Calendar rhythm method (CM), 99, 107-108, 189 Cancer, protection against, 96, 102, 111, 178, 181, 220, 407 Cell-mediated immune (CMI) responses, 461-462, 463 Center for Population Research (CPR), 114, 238, 278, 288 Cervical cancer, 78, 193, 195, 220 Cervical cap, 98, 114, 189, 261, 268, 431-432, 496 Chancroid, 78, 194, 496 Chemical barrier methods, 105, 115-117, 431 China, 65, 67, 68, 82, 112, 167, 170, 251 Chlamydia, 78, 79, 157, 193, 194, 195, 496 Chlorhexidine, 439, 441 Cholera toxin, 458 Ciba, 237 Clinical trials, 11, 19, 20, 299-300, 346 c-mos proteins, 143, 144, 389 Coitus interruptus (withdrawal), 100, 172n, 189, 504 Colony-stimulating factor (CSF-1), 136, 368-369 Combined oral contraceptives (COCs), 96, 100, 102, 109, 189, 268 Condoms, 98, 105-106, 171, 175, 177, 179, 189, 381, 497 female, 25, 93n, 98, 105, 106, 179, 189, 240, 431 firms making and distributing, 260, 261, 262, 263, 265 nonlatex, 106, 240 protection against infections, 31, 34, 80, 81, 98, 179, 192, 224, 431 sales and market shares, 201-202, 203, 204, 206, 264 worldwide use and supply, 169, 170, 172-173, 174, 212, 214-215 Consortium for Industrial Collaboration in Contraceptive Research (CICCR), 19, 281, 287, 346 Consumer decisions and preferences, 23, 170, 186, 195-198 of men, 234n Consumer education, 24-25, 328-329 Contraceptive and Reproductive Evaluation Branch, 278

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-->   Contraceptive Development Branch (CDB), 278 Contraceptive Research and Development (CONRAD) program, 114, 238, 280 "Contraceptive revolution," 29-30, 236-237 development of a second, 16, 34-35, 45n Contraceptive use, 167-171, 175, 177, 200-201 worldwide, 167-170, 172-173, 174, 207 see also Discontinuation of methods Contract research organizations (CROs), 248-250, 291 Copper T 380A IUD, 97, 104, 109, 123n, 189, 217, 226, 234n, 240 Costs and cost-effectiveness, 8, 54-55, 201-203, 213, 216-228 of infection prevention, 219-220 of labeling improvements, 25-26 societal, 16-17, 54, 55 C31G, 441 Cytokines, 136, 138-139, 359, 368-372 D Dalkon Shield, 23, 182, 190, 237, 315-316 Defensins, 443 Demand, see Market demand; Unmet needs for contraception Depo-medroxyprogesterone acetate (Depo-Provera, DMPA), 23, 97, 102 , 104, 112, 113, 189, 190, 203, 237, 263, 497 regulatory issues, 21, 295, 297, 338-339n Detergents and surfactants, 434, 437, 439 Developing countries abortion in, 65, 72, 73, 74 contraceptive use in, 18, 30, 167, 168, 169, 170, 173, 174, 176, 181, 207, 217, 223 discontinuation, 183-187 failure of methods, 184-185 family planning in, 45n, 54, 68-69, 213, 216 impacts of U.S. regulatory actions, 295, 338n market demand in, 203-208 maternal deaths in, 72, 73, 74, 76 pharmaceutical industry in, 39, 238 sources of contraceptive supply, 17, 18, 51, 206, 208, 214-215, 343 Diaphragms, 98, 172n, 174, 175, 177, 189, 204, 497 firms making and distributing, 260, 262, 263, 264, 265 protection against infections, 81, 431-432 Diethylstilbestrol (DES), 315, 339-340n Discontinuation of methods, 170, 183-190 failure as factor in, 185, 187 side effects as factor in, 6, 183, 186, 187, 197 Djerassi, Carl, 2, 236 Docosanol, 442 Dow Coming, 317, 340n Drug delivery systems, 112-114, 134, 141, 269, 422, 457-460. See also Hormone-releasing IUDs; Implants; Injectables; Vaginal methods Dual use, 192-193 Duty of care, 305, 307 E Early conceptus antigens, 14, 150-151, 154, 345, 406, 409-412 Ectopic pregnancy, 137, 219, 224, 363, 497-498 Effectiveness, see Failure and efficacy Efficacy, see Failure and efficacy Egg surface antigens, 151, 152, 406, 412-413 Eli Lilly, 239 Emergency contraception, 24, 100-101, 109-110, 182, 261, 363 basic research for, 134-135 costs and savings, 217, 218-219 IUD used in, 101, 109

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-->   mifepristone used in, 101, 109, 117, 134, 135, 364 pill used as, 100-101, 109, 124n, 182, 234n, 363-364 Emergency contraceptive pills (ECP), 100-101, 109, 124n, 182, 234n, 363-364 Endometrial cancer, 96, 102, 111, 178, 220 Enzyme inhibitors, 13, 135, 344 Epididymal function, 14, 146, 147-148, 345, 383, 384-385, 390, 394 -396 Epostane, 135, 365 Estradiol, 134, 260 Estrogen receptor, 134, 360 Europe, 76, 77, 170, 172, 174, 194, 195, 206, 208, 214, 251 Express warranty, 306 F Failure and efficacy, 7, 24, 48, 183, 188-190, 196, 234n of anti-infectives, 20, 346 as factor in discontinuance, 185, 187 by method, 96-101 regulatory requirements, 105, 297-298 and unintended pregnancy, 30, 96-101, 189 of vaginal preparations, 437-438 Family Health International (FHI), 119, 238, 280 Family planning in developing countries, 45n, 54, 68-69, 213, 216 effect on population growth, 5-6, 45n in integrated reproductive health system, 17, 45n, 344 men's involvement in, 82-83, 84-85, 86, 87, 181 Federal standards defense, see Government standards defense Female condom, 25, 93n, 98, 105, 106, 179, 189, 240, 297-298, 329, 431 firms making and distributing, 261, 263 Female methods, 96-101 immunocontraception, 11, 12, 14, 150-157 passim, 199-200, 345, 405-408 protection against infection, 10, 13, 48, 342, 344, 430-432 research and development, 10, 130-141, 342, 344, 351-374 see also Barrier methods; Cervical cap; Diaphragms; Emergency contraception; Female condom; Fertility Awareness Methods; Implants; Injectables; Intrauterine devices; Lactation Amenorrhea Method; Menses-inducers; Microbicides; Oral contraceptives; Ovulation inhibition; Periodic abstinence; Postimplantation technologies; Spermicides; Tubal sterilization; Vaginal methods FemCap, 114 Fertilin, 147, 393, 398 Fertility Awareness Methods (FAMs), 100, 108 Fertility preferences, see Reproductive preferences Fetal exposure, 20, 346 Fibroblast growth factors (FGFs), 136, 371-372 Fibronectin, 135 Fogarty, John E., International Center, 279 Follicle-stimulating hormone (FSH), 128, 142, 352, 360, 384, 385, 406-407, 498 immunogens, 152, 155, 408-409 inhibition, 14, 119, 129-131, 132, 133, 144, 345, 353, 355-356, 357 -358, 386-388 Follicular atresia, 13, 131, 344, 354-355 Follicular development, 133, 354, 361 Follicular rupture, 13, 131, 344, 356, 361 Follistatin, 132, 353 Food and Drug Administration (FDA), 20, 23, 25, 105, 254, 296-298, 339n class labeling of oral contraceptives, 112

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-->   and emergency contraceptive pills, 109-110, 234n IUD approval, 123n and multicomponent drugs, 155, 300-301, 423-424 reform proposals, 20, 301-302 Formularies, 242-243, 244 Fraudulent representation, 306 Frivolous lawsuits, 312 G Gamete interaction inhibition, 147, 148-149, 397-398 Gene therapy, 145, 360, 389-390, 424-425 Genetics, 11, 126-128, 343, 422 gamete development, 14, 345, 358-359 and sperm development, 143, 145, 389-391 Germ cell nuclear factor (GCNF), 133, 359 Global Contraceptive Commodity Programme, 18, 344-345 Glycoproteins, 135, 366-367, 384, 412 Gonadotropin-releasing hormone (GnRH) and receptors, 128, 130, 139 , 142, 351-352, 360, 385 agonists, 128, 129, 132, 352-353 antagonists, 13, 128, 132, 137, 344, 353, 374 immunogens, 152, 155, 352, 406-408 Gonorrhea, 78, 79, 157, 193, 194, 195 Gossypol, 116, 120, 498 Government standards defense, 20, 22, 23, 311, 312, 314-315, 346 Government support, 218, 227-228 for contraceptive supply, 17, 18, 206, 208, 212-213, 214-215, 343 of research and development, 18-19, 29-30, 39, 40-41, 237-238, 273 , 278-279, 283, 286-290, 345-346 gp130 protein, 370-371 Granulosa cell layer, 357-358 Growth factors, 136, 138-139, 360, 371-371 Guidelines, see Regulation H Health maintenance organizations (HMOs), 17, 55, 225-226 Heparin-binding epidermal growth factor (HB-EGF), 136, 367 Hepatitis B virus (HBV), 79 Herpes simplex virus (HSV), 14, 78, 79, 345 High-molecular-weight (MW) glycoprotein, 135 Hormonal methods, 35, 96-97 protection against infections, 81, 96-97, 102, 103, 178 see also Implants; Injectables; Oral contraceptives Hormone-releasing IUDs, 113 Hughes, Howard, Medical Institute (HHMI), 284 Human chorionic gonadotropin (hCG), 150-151, 154, 409-412, 423 inhibition, 139, 372 Human Immunodeficiency Network (HIV/NET), 114, 115 Human immunodeficiency virus (HIV), 14, 78, 79, 80, 219, 345, 431, 434-436 Human papilloma virus (HPV), 14, 78, 79, 193, 195, 345 Hydrogen peroxide, 444 I Iatrogenic reproductive tract infections, 45n, 93n Immune-stimulating complexes (ISCOMs), 458-459 Immunocontraception, 234-235n basic research, 12-13, 14, 343, 401-425 female methods of, 11, 12, 14, 150-157 passim, 199-200, 345, 405-408 male methods of, 119, 152, 155, 405-409 reproductive hormones as antigens, 14, 152, 155-156, 345, 406

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-->   research and development, 149-157, 199-200, 267, 269, 270 see also Early conceptus antigens; Egg surface antigens; Mucosal immunology; Sperm antigens Implantation, see Anti-implantation methods; Blastocyst implantation; Postimplantation technologies Implants, 21, 96, 103, 112-113, 178, 189 firms making and distributing, 260, 263 Infections, see Bacterial infections; Pelvic inflammatory disease (PID); Reproductive tract infections (RTIs); Sexually transmitted diseases (STDs); Viral infections Informed choice, 23-25, 326-328 and packaging information, 24, 25-26, 328-329, 346-347 Informed consent, 24, 307-308, 318, 325, 327, 340n Inhibin, 132, 267, 353 Injectables, 97, 104, 112, 113-114, 237, 240, 263, 269, 270, 499 worldwide use and supply, 169, 172-173, 174, 178, 214 Inserts, 26, 328-329 Institute for International Studies in Natural Family Planning (IISNFP) , 238 Institutional Review Boards (IRBs), 318, 325 Insulin-like growth factor (IGF-1), 136, 371 Insurance contraceptive coverage under, 17, 225-227 product liability, 304, 318, 323 Integrins, 135, 366 Interleukin-1 (IL-1), 136, 368 International agencies, 18-19, 273, 282, 287, 291. See also Nongovernmental organizations (NGOs); World Health Organization (WHO) International Conference on Population and Development (Cairo conference) , 32, 40-41 International Planned Parenthood Federation, 235n Intrauterine devices (IUDs), 20, 23, 29, 35, 45n, 97, 104, 113, 123 -124n, 171, 177, 178, 189, 190, 191-192, 205, 315-316, 500 as emergency contraceptive, 101, 109 firms making and distributing, 237, 260, 261, 264, 265 and infections, 45n, 81, 93n, 182 worldwide use and supply, 169, 170, 172-173, 174, 176, 212, 214-215 see also Copper T 380A IUD; Dalkon Shield; Progesterone T IUD J Japan, 65, 67, 68, 82, 112 Johns Hopkins University, 115 K ''KAP (knowledge, attitudes, practice)-gap," 51, 68, 92n L Labels and labeling, 25-26, 328-329, 346-347 Lactation Amenorrhea Method (LAM), 99, 107 Lactobacillus, 457-458 Latin America and the Caribbean, 65, 68, 76, 167, 173, 174, 185, 194, 208, 215, 251 LDH-C4 (LDH-X) protein, 153, 154, 415-417 Lea's Shield, 114, 240, 271 Legal issues, see Product liability; Regulation; Tort law Leukemia inhibitory factor (LIF), 136, 138-139, 369-370, 374 Levonorgestrel (LNg) implant, 96, 102, 112, 321-322 injectable, 113-114 IUD, 97, 104, 189, 234n

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-->   Life cycles and life spans, 55-58 women's reproductive life span, 31, 48, 56-58, 60-63, 86-87 Liposomes, 459-460 Long-loop feedback system, 142, 144, 384, 385 Luteinizing hormone (LH), 128, 142, 352, 353, 356, 360, 384, 385, 406, 500 inhibition, 14, 119, 129, 134, 345 Luteolytic agents, 13, 139, 362, 372-372 M Male methods, 31, 48, 81-83 basic research, 10, 14, 345, 381-399 immunocontraception, 119, 152, 155, 405-409 research and development, 10, 83, 119-120, 142-149, 269, 271, 342 see also Condoms; Vasectomy; Withdrawal Managed care industry, 55 and pharmaceutical industry, 225, 242-243, 246 Marital status, 69, 70, 71, 74, 75 Market capitalization, 241, 242, 252 Market demand, 6, 48-49 in developing countries, 203-208 indicators of, 6-9, 49, 200-213 and subsidized procurements, 210-213 and unmet needs, 15-19, 166-167, 343-346 Maternal deaths, 48, 74, 76, 78, 93n Maturation promoting factor (MPF), 132 Mead Johnson, 239, 260, 262 Mechanical barrier methods, 105-106, 114-115, 431 Medicaid, 227, 228 Meiosis interventions, 14, 131, 132, 143, 144, 345, 356-357, 388-389 Melatonin, 111, 133 Mellon, Andrew W., Foundation, 284, 287, 288 Men, involvement in family planning, 82-83, 84-85, 86, 87, 181. See also Male methods Menopause, 45n, 58, 61, 63, 500 Menses-inducers, 10, 13, 14-15, 134-135, 139-141, 342, 343, 344, 373 Merck,, 237, 241, 266, 269 Microbicides, 80, 81, 115-116, 431, 434, 436-445 passim regulatory issues, 20, 346 Middle East and Arab States, 65, 68, 76, 167, 172, 174, 194, 195, 208, 214 Mifepristone (RU 486), 117, 139, 141, 253, 365-366, 373 controversy over, 14, 118, 272 as emergency contraceptive, 101, 109, 117, 134, 135, 364 Milk fatty acids, 439 Minipill, see Progestin-only pill Mistimed pregnancy, 59, 64, 65, 66-67, 68, 69 Molecular biology, 11, 125-128 Monoclonal antibodies (MAbs), 245, 444, 445 Monthly methods, 13, 118, 139, 342, 344, 372 research, 10, 13, 14-15, 134-135, 139-141, 343, 344, 373 Morning-after pill, see Emergency contraceptive pills (ECP) Muc-1 (episialin), 135, 367 Mucosal immunology, 156-157, 446-451, 462-463 compartmentalization in, 455 in females, 156-157, 451-453, 460-461, 462-463 in males, 453-455, 461, 462-463 oral administration, 157, 456-460 Müllerian inhibiting substance (MIS), 359 Multideterminant immunogens, 155-156, 414-420 Multilateral purchasing pools, 18, 211, 344-345 N National Institute of Allergy and Infectious Disease (NIAID), 115

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-->   National Institute of Child Health and Human Development (NICHD), 19, 114, 115, 238, 278, 288 National Institutes of Health (NIH), 278, 279, 288, 290 National Survey of Family Growth (NSFG), 58-59, 92n, 234n National Vaccine Injury Compensation Program (NVICP), 23, 310-311, 331-332 National Women's Health Network, 299 Natural family planning, 81, 99. See also Non-commodity-based methods; Periodic abstinence Needs, see Market demand; Unmet needs for contraception Neem oil, 116, 442 Negligence, 305, 307-308 New chemical entities (NCEs), 253-255 New drug applications (NDAs), 299, 301, 339n Non-commodity-based methods, 99-100, 106-108. See also Natural family planning; Periodic abstinence Nongovernmental organizations (NGOs), 214-215, 273 Nonoxynol-9, 105, 115, 439 Nonprofit organizations partnerships with pharmaceutical industry, 15, 19, 240, 266, 267-271, 343 research support, 15, 40-41, 238, 273, 277, 279-281, 283, 286, 287 , 288, 290, 343 Norethindrone, 113, 114, 236 Norplant, 21, 96, 102, 103, 112-113, 170, 189, 202, 203, 205, 240, 269, 340n firms making and distributing, 260, 263 litigation and controversy, 23, 103, 182, 203, 319-322 O Off-label use, 109-110, 234n Oocyte maturation inhibitor (OMI), 132 Oral contraceptives (OC, Pill), 29, 96, 171, 175, 178-179, 181, 183 , 188, 189, 190, 226, 500 as an emergency (postcoital) method, 100-101, 109, 124n, 182, 234n, 363-364 combination pill, 96, 100, 102, 109, 189, 268 firms making and distributing, 237, 260, 261, 262, 263, 264, 265, 266 progestin-only (minipill), 96, 101, 103, 109, 123n, 189, 267, 270, 363 protection against infections, 96, 102, 178, 181 research and development, 110-112, 237, 238, 267, 268, 270 sales and market shares, 201, 202-203, 204, 264 worldwide use and supply, 169, 170, 172-173, 174, 176, 202, 212, 214-215 Organon International, 46n, 237, 238, 239, 259, 260, 262, 264, 266 , 269, 272 Orphan receptors, 131, 133, 358-359 Ortho Pharmaceutical Corporation, 46n, 234n, 237, 239, 259, 260, 262, 264, 266, 269 Outsourcing, 248-250 Ovarian cancer, 96, 102, 111, 178, 220 Oviductal transport and retention, 137-138, 362-363 Ovulation inhibition, 13, 111, 131, 137, 139, 140, 344, 351-361 Ovulation method (OM, cervical mucus method), 99, 108, 189 Oxytocic agents, 134 P Packaging information, 24, 25-26, 328-329, 346-347 Parke-Davis, 237, 239, 260, 262, 264 Pelvic inflammatory disease (PID), 195, 224, 501 abortion as cause of, 74-75 IUDs as cause of, 45n, 123n, 178

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-->   methods protecting against, 81, 96-97, 102, 111, 178 Periodic abstinence, 99, 107-108, 172n, 174, 175, 188, 189, 190, 501. See also Natural family planning; Non-commodity-based methods Pharmaceutical industry, 242-244, 246-247, 259, 264, 290-291 factors affecting research involvement, 14-15, 16, 34-37, 46n, 236 -244, 253-272 and managed care industry, 225, 242-243, 246 partnerships with nonprofit organizations, 15, 19, 240, 266, 267-271, 343 revenues and sales, 241, 252, 265, 266 small firms, 15, 19, 239-240, 346 see also Biotechnology industry Pharmacy benefit management organizations (PBMs), 242-243 PH-20 protein, 147, 149, 151, 153, 154, 393, 398, 419 Physical barriers, see Mechanical barrier methods Pill, see Oral contraceptives Point of service (POS) networks, 226 Political controversy, 36, 290, 329-333 over abortion, 14, 331 over antiprogestins, 14-15, 118, 272 over postimplantation methods, 14, 15, 331, 343 Population Council, 45n, 83, 116, 238, 280-281 and mifepristone, 14, 118 Population growth, effect of family planning on, 5-6, 45n Postcoital methods, 48, 109-110, 363-364 emergency contraceptive pills, 100-101, 109, 124n, 182, 234n, 363-364 research and development, 117-118, 134-137 Postimplantation technologies, 15, 361-374 controversy over, 14, 15, 331, 343 see also Menses-inducers Postmarketing surveillance, 23, 346 Postovulatory methods, 48, 137-141 Preferences, see Consumer decisions and preferences; Reproductive preferences; Unintended pregnancy Preferred provider organizations (PPOs), 226 Pregnancy, 56, 57, 65, 70, 79, 302. See also Ectopic pregnancy; Maternal deaths; Reproductive preferences; Unintended pregnancy Private sector, see Nonprofit organizations; Pharmaceutical industry Product liability, 21-23, 237-238, 303-304 for biomaterials suppliers, 21, 311, 317-318 breast implant litigation, 317, 340n DES litigation, 315, 340n injuries to offspring, 308-309 insurance, 304, 318, 323 and research, 21-23, 257, 305, 307-308, 318-319 rules of, 304-309 see also Tort law Progestasert, 97, 104, 191, 238 Progesterone antibodies, 135, 365 Progesterone synthesis inhibitors, 135, 365, 366 Progesterone T IUD, 97, 104, 189, 234n Progestin-only pill (POP, minipill), 96, 101, 103, 109, 123n, 189, 267, 270, 363 Program for Applied Research in Fertility Regulation (PARFR), 238 Program for the Topical Prevention of Conception and Disease (TOPCAD) , 281 Program in Appropriate Technology (PATH), 281 Prostaglandin synthase2 gene (PGS-2), 131, 134 Prostate cancer, 407 Protectaid, 115 Public sector, see Government support; International agencies Punitive damages, 310, 311, 312, 316-317

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--> R Reality female condom, 25, 105, 106, 240, 297-298, 329 Regulation, 20, 237, 346 of anti-infective methods, 20, 297-298, 346 of combination products, 155, 300-301, 423-424 international harmonization, 20, 39 reforms, 20, 301-302 safety data requirements, 296-297 Reproductive biology, 19, 128-130, 291 Reproductive hormones, as antigens, 14, 152, 155-156, 345, 406 Reproductive preferences, 50-51, 60-61, 66-67, 68-69, 86, 192 and actual birth control practices, 51, 68, 92n Reproductive tract infections (RTIs), 45n, 93n sexually transmitted, 45n, 78-81, 93n, 223-225 Reprogen, 156 Research and development, 15, 16, 34-37, 46n, 236-244, 253-272 anti-implantation methods, 15, 137-139, 343, 364-368 barrier methods, 10, 12, 13, 114-117, 343, 430-444 costs and returns, 253-258 drug delivery systems, 112-114, 134, 141, 269, 422, 457-460 female methods, 10, 130-141, 342 government support of, 18-19, 29-30, 39, 40-41, 237-238, 273, 278-279, 283, 286-290, 345-346 immunocontraception, 149-157, 199-200, 267, 269, 270 informed consent of subjects, 307-308, 318, 325, 327, 340n international agency support of, 18-19, 273, 282, 287, 291 liability issues, 21-23, 257, 305, 307-308, 318-319 male methods, 10, 83, 119-120, 142-149, 269, 271, 342 and multilateral purchasing pools, 18, 344-345 nonprofit organization support of, 15, 40-41, 238, 273, 277, 279-281, 283, 286, 287, 288, 290, 343 see also Basic science and research Research Triangle Institute (RTI), 279 Risks, see Side effects and health risks Robins, AH, 237, 315 Rockefeller Foundation, 39, 284, 287, 288, 293n Contraception 21 Initiative, 38, 198 Roe v. Wade Supreme Court decision, 75, 331 Roussel Uclaf, 14, 46n, 118, 239, 253, 270, 272 RSA-1 protein, 153, 417-418 RU486, see Mifepristone S Safety and dangers, 196, 296-297 of selected methods, 96-101 see also Side effects and health risks Salk Institute, 279 Saturation mutation, 126-127, 502 Schering AG, 46n, 109, 237, 238, 239, 260, 263, 264, 270 Schering Plough, 260, 263 Schmid, 237, 260 Science, see Basic science and research; Research and development Searle, 237, 239, 260, 263, 264, 315 Serine proteinase inhibitors, 442-443 Sexuality, 330 Sexually transmitted diseases (STDs), 33-34, 195, 433-434, 502 anti-infective research and development, 10, 11-12, 276-277, 342 costs and benefits of prevention, 80, 219, 223-225 female reproductive tract infections, 45n, 78-81, 93n, 223-225 as indicator of contraceptive demand, 7-8, 48, 192-193

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-->   protection against, 31, 80-81, 96-98, 114-116, 179-180, 297-298, 430-432, 434, 437 worldwide rates, 193-195 see also Human immunodeficiency virus (HIV) SF-1 (steroidogenic factor 1), 132, 133, 359 Side effects and health risks, 24, 170, 171-173, 176, 178-180, 181 -183, 196, 502 as factors in discontinuance, 6, 183, 186, 187, 197 by method, 96-101, 178-180 Silicone medical implants, 21, 103, 317, 321, 340n Social climate, 9, 26, 36-37, 290, 329-331 Sperm antigens, 12, 14, 146, 151, 153, 154-156, 345, 396, 406, 413-421 Sperm development disruption, 14, 119-120, 142-143, 144-146, 147-148, 345, 382-384 acrosome and tail formation, 143, 145, 390-392 epididymal function, 14, 146, 147-148, 345, 383, 384-385, 390, 394 -396 genetic manipulation, 143, 145, 389-391 surface protein alteration, 145-146, 392-394 Sperm-egg fusion, 13, 149, 344, 361, 397-398 Spermicides, 13, 98, 105, 115-116, 180, 189, 205, 344, 436-445, 503 firms making and distributing, 260, 261, 262, 263, 264, 265 protection against infections, 81, 181 regulatory issues, 20, 346 see also Microbicides Sperm transport, 13, 344 sp56 protein, 153 Sponge, 115, 172n, 240, 263, 293n, 503 SP-10 protein, 153, 154, 156, 419-420, 422 Squalamine, 116, 442 State government, 227, 228 STD, see Sexually transmitted diseases (STDs) Sterilization, 74, 169, 174, 175, 189, 191-192, 217, 226, 238-239, 271 and availability of reversible methods, 191, 192 as indicator of contraceptive demand, 7, 30-31, 48, 204-206 worldwide use, 169, 172-173, 174, 176, 204-206, 212, 214-215 see also Tubal sterilization; Vasectomy Steroid hormone receptors, 111, 134, 137, 360, 361 Strategic alliances and partnerships, 248, 250, 251, 267-271 Strict liability, 307, 308, 323 Sulfated polymers, 440, 443 Superagonists, 352-353 Symptothermal method (STM), 99, 108 Syntex, 237, 239, 260, 263, 264 Syphilis, 78, 79, 193, 194 T Tamoxifen, 134, 360 Tcte-1 protein, 153, 418-419 Teenagers, 188, 190 abortions among, 75 pregnancy, 71, 87, 92n, 217, 219 sexually transmitted diseases, 195 Third-party payers, 17, 51, 54, 55, 214-215, 225-227, 343. See also Government support Title X, funding of contraceptive services, 227, 228 Today sponge, 21, 240 TOPCAD, see Program for the Topical Prevention of Conception and Disease Tort law, 304-309 government standards defense, 20, 22, 23, 311, 312, 314-315, 346 and informed consent, 324-325 punitive damages under, 310, 311, 312, 316-317 reform proposals, 20, 309-319, 322-324

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-->   and scientific evidence, 304, 339n time limits under, 312, 313 see also Product liability Traditional methods, see Non-commodity-based methods Treponema pallidum, see Syphilis Trichomoniasis, 193, 194, 195 Tripterygium wilfordii, 120 Tubal sterilization, 167, 170, 174, 191, 226 2-D electrophoresis, 423 U UNFPA, see United Nations Population Fund Unintended pregnancy, 3-5, 30, 58-59, 92n, 170 and abortion, 70, 71-76 from contraceptive failure, 30, 96-101, 189 costs and cost avoidance, 54, 188, 213, 217, 218, 222 rates of, 4-5, 59, 64-71, 75 worldwide, 59, 64-67, 68-69 United Nations Population Fund (UNFPA), 211, 212, 235n, 282 Universities, 238, 277, 281 Unmet needs for contraception, 49-50, 52-53 indicators of, 4-6, 30-31, 86-88 and market demand, 15-19, 166-167, 343-346 Unwanted pregnancy, 59, 64, 65, 66-67, 68, 69 Upjohn Company, 237, 239, 263, 270, 297 USAID, see Agency for International Development V Vaccines, 208-213, 331-333, 401-402 injury compensation program, 310-311, 331-332 see also Immunocontraception Vaginal methods, 157, 432 hormonal delivery, 113, 134, 270, 363 protection against infection, 116, 431, 434, 436-438 regulatory issues, 20, 298-300, 346 research and development, 13, 344, 436-444 Vaginal ring, 113, 240, 270 Vaginal sponge, 115, 172n, 240, 263, 293n, 503 Value, see Costs and cost-effectiveness Vasectomy, 119, 174, 177, 226, 240, 381-382, 398 Vectorial labeling, 423 Viral infections, 45n, 79, 81, 93n, 193, 434. See also Hepatitis B virus; Herpes simplex virus (HSV); Human immunodeficiency virus (HIV); Human papilloma virus (HPV) Virtual integration, 248, 249 Virtual partnerships, 19, 291 W Wanted pregnancy, 65, 66-67 Whitehall, 259, 260, 263, 271, 293n Withdrawal (coitus interruptus), 100, 172n, 189, 504 "Woman-centered agenda," 2-3, 31-33, 198-200, 342 in setting research priorities, 10, 19, 32-33, 342, 346 Women in clinical trials, 302, 308-309, 325, 326-327, 340n reproductive life span of, 31, 48, 56-58, 60-63, 86-87 see also Abortion; Female methods; Maternal deaths; Pregnancy; Reproductive tract infections; "Woman-centered agenda" Women's Global Network for Reproductive Rights (WGNRR), 199 World Bank, 282

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-->   World Health Organization (WHO), 119, 151, 235n and approval guidelines development, 20, 346 Special Programme of Research, Development, and Research Training in Human Reproduction (WHO/HRP), 114, 199-200, 238, 282, 364, 366 Wrongful life, birth, or death, 309 Wyeth-Ayerst, 237, 238, 239, 259, 260, 263, 264, 266, 271, 319-320 Y Yuzpe Regimen, 109, 363 Z Zona pellucida (ZP) proteins, 146-147, 148, 151, 152, 396-397, 398 , 412 Zona receptor kinase (ZRK), 147, 148, 149, 396, 398