Medicine: Blocks And Barriers

More than half a million U.S. women are unable to bear children because their Fallopian tubes have been blocked or damaged, usually by sexually transmitted infections. Yet the risk of tubal infertility can easily be reduced. How? By the use of so-called barrier contraceptives -- diaphragms, cervical caps and condoms -- which bar the passage of sperm into the uterus.

That was the conclusion reported last week in the Journal of the American Medical Association by a team led by Gynecologist Daniel Cramer of Boston's Brigham and Women's Hospital. After studying past contraceptive use by 283 childless women with tubal infertility and 3,833 new mothers, the researchers found that women who had used barrier contraceptives had 40% less risk of tubal infertility. The explanation, suggests one of the report's authors, Harvard Epidemiologist Marlene Goldman, is that these contraceptives prevent any germs carried in the semen from reaching the upper genital tract and causing pelvic inflammatory disease, the most common cause of tubal infertility. Concluded Willard Cates, of the Centers for Disease Control, in an accompanying editorial:"The ulimate educational message is that barrier methods ((ideally used with spermicides)) will not only prevent unplanned pregnancy in the short run but also preserve desired fertility in the future."