@-Newsletter

Volume 1 • Number 4 • Dec. 2004

Message from the ESC President

Dear ESC members, dear colleagues,

I am glad to announce that our newsletter has become a very useful information tool for motions and new developments in the ESC. I would like to see it even more interactive with your contributions.

The period between an ESC congress and seminar may seem quiet, however, many decisions are taken, new challenges appear, upcoming meetings are prepared. I wish to report on a few interesting items from the current agenda:

° ESC Journal.

The editorial office of the journal was successfully transferred from Athens to Brussels. From now on, all new manuscripts should be submitted to the ESC Central Office. The review process is now carried out electronically and all future authors are requested to submit articles by email ([email protected]). This significantly speeds up the whole process from submitting to publishing a paper. Together with the recently obtained impact factor, this further increases the value of the journal.

Another new aspect in the production of our journal is our new publisher, Taylor & Francis. Unfortunately, as a negative consequence of this change, our September issue was substantially delayed. We are however assured by the publisher that the future co-operation will go smoothly.

° Congress in Istanbul 2006.

Currently, it is the right time to contribute significantly to the structure and general content of the scientific programme. Are you aware of an interesting and/or new topic or have you attended a brilliant lecture which should not be omitted during our congress? Please send your suggestions to the Central office! All proposals will be carefully discussed by the Scientific Committee.

° ESC website.

Following the recent congress in Edinburgh, all abstracts are available, as well as many reports from meet the expert sessions and workshops (http://www.contraception-esc.com/

edinburgh.htm -> go to 'Reports and evaluation').

I wish you the ability to successfully defend, in this hectic life, your private time during Christmas Eve.

Sincerely yours, David Cibula

Contribution to this newsletter

Poland: from abortion to contraception... and back

by Medard M. Lech MD, PhD, FPCOG

Poland, with its 38.5 million population, is one of the biggest Central European countries. Just recently Poland has become a member of the European Union. Historically, induced abortion has been a common method of birth control in Poland, especially due to the wide use of less effective contraceptive methods and difficult accessibility to modern contraceptives (i.e. any method other than the rhythm method or coitus interruptus).

Induced abortions

Poland belongs to the group of countries where abortion was legally and widely available since the middle of the XX century. The very early legalization (1953 and 1956) of abortions in Poland was, most probably, an official reaction to the post-war baby boom and the fear of imminent and rapid overpopulation of the country. Since then, the official numbers of abortions performed in Poland have never been complete, but even so they have been high (in the range of 20-40% of the total number of live births). In 1965, there were 546,000 total live births, 169,000 induced abortions and 76,000 other abortions. Parallel to the declining of numbers of live births and total fertility rate (from 2.52 in 1965 to 2.03 in 1990), the number of induced abortions was also declining. In 1990, the numbers of live births and induced abortions were respectively 545 and 59 thousand, with the number of “other abortions” as high as 59 thousand. The transition of the political system in Poland in the years 1989-1995 drew very much attention to the high number of induced abortions and as a result of it, the abortion law was dramatically changed from “legal – on request” to “illegal”. The “new law” (1997) has implemented the total prohibition of induced abortions for social reasons. According to official statistics, the number of induced abortions in Poland is stabilized on a level of 150-200 per year (in ~ 9 million women of childbearing age!). Unofficial sources estimate this number to be at least five hundred fold higher.

Hormonal contraception

The first scientific publication regarding contraceptive use in Poland was published in 1974, when use of methods, other than rhythm, was very low. From this publication is known that, in the early seventies, one condom had fallen for one men aged 15-60 per year, and one contraceptive pill had fallen for one women in the age of 15-49 per year. Hormonal contraception was and is provided mostly by gynecologists, and only a very few formulations (2nd generation combined oral contraceptives - COC) are partially paid for by general health insurance. Since 1974, the number of women using COC is slowly and constantly increasing. Some sources provide prevalence rates of oral contraception as high as 19%; more conservative sources provide estimates within the range of 11% to 15%. But the situation is changing rapidly; more and more patients are seeking safe and effective methods. It is estimated that approximately 700,000 women in Poland are using COCs in the most recent years.

Depo-Provera® and progestogen-only pills (the only formulation being 0.075 mg of desogestrel) are available in Poland, but not so any progestogen implant.

Barrier contraception

The condom is the only reversible male contraceptive available in Poland. In recent years, the rate of use of condoms is very high, and this method common (only coitus interruptus and rhythm method are more popular than condoms). The female condom is not available. Diaphragms and cervical caps are extremely rarely used by the Polish women.

Spermicides

A wide variety of spermicides (vaginal tablets, foam, cream) containing Nonoxynol-9 is available in Poland, but this method is not popular.

Sterilization

Permanent sterilization (both vasectomy and tubal ligation) is prohibited in Poland.

Abortion again

The official number of abortions in Poland is less than 200 per year (0.022/1000 women aged of 15-49), but in reality, the estimated number exceeds 50-100,000 (or even more) abortions per year. The restrictive abortion law in Poland means also that “safe abortion services are only available to well-off women” (due to the availability of these services in the “abortion underground”, as well as to the easy access of these services in neighbouring countries). The fight for the contemporary and democratic abortion law (similar to abortion laws in most European countries) is one of the very hot political points in Poland. Some groups in society, the women’s rights lobby, NGOs and some of the health professionals are trying to influence politics by: raising awareness, monitoring and initiating activities concerning reproductive health/rights and women’s rights in the community, initiating media campaigns (through reports, press conferences, fact sheets, press releases, NGO’s bulletins, open letters, etc.) on legalization of abortion and introducing sex education at schools, advocating implementation of the commitments made by the Government during the international conferences (Cairo Conference on Population and Development, Beijing Fourth World Conference on Women), formation of various national and international networks and coalitions (including the Polish Committee of NGOs-Beijing ’95), promoting international standards concerning human rights in the area of women’s reproductive health and rights.

By Medard Lech, MD, PhD, FPCOG, Fertility and Sterility Research Center, Warszawa, Poland

Museum for contraception and abortion

New museum wants old contraceptives

Working in routine clinical practice, one realises that people today do not even imagine that controlling fertility could have been a problem for past generations. Consequently we are frequently confronted with the request to recommend a “safe and natural” contraceptive. Young patients of today do not consider for a second that “safe and natural” is a complete contradiction when it comes to contraception. The lack of understanding of the need for “artificial” contraception is not purely academic. Consequently no one will be able to use a safe contraceptive whilst they do not understand what is at stake; that is as long as they do not understand the incredible force of fertility.

The goal of this museum is to show how desperate former generations have been to control their fertility, resorting to all sorts of ineffective and/or dangerous methods that sometimes look funny from our point of view. But people at that time had very little understanding of reproductive physiology and few means. The goal of this museum is also to show the incredible fantasy they had to at least limit fertility. It is my hope that this museum will lead to a better understanding of fertility and the need to control it. I also hope that this will contribute to a better contraceptive

behaviour.

We have so far collected objects and publications for this new museum since June 2003. We have already made quite a lot of progress although it is a difficult task. Nobody attaches any value to old contraceptives let alone abortion instruments. Also we have an agreement with the Institute of Medical History of the University of Vienna and Zurich. They have given us objects on loan.

Nevertheless, we are calling on health professionals to donate historic contraceptives or instruments that have been used to induce an abortion or publications about these topics. We are looking for all sorts of articles (IUDs, cervical caps, etc), films, publications, testimonies and information about these topics. Any information on historic pregnancy tests is also most welcome, for example the famous Mainini-Test using frogs.

We have rented 4 rooms at a very central location in Vienna and are currently adapting them for the museum. Our plan is to open to the public in Spring next year.

All objects and publications will also be displayed on the website and the donors will be acknowledged. A preliminary version of the website is already available.

Thank you in advance for your support and kind consideration.

By Christian Fiala, MD
Specialist in OB/Gyne
Gynmed Ambulatorium GmbH
Mariahilfergürtel 37, A-1150 Wien
Hotline 0699 178 178 00
E-mail: [email protected]

www.gynmed.at

Practical information:

Museum of contraception and abortion

Mariahilfergürtel 37, A-1150 Wien

Phone: +43 699 178 178 04 (Susanne Krejsa PhD) and +43 699 159 731 90 (Christian Fiala MD)

Fax: +43 1 892 25 81

Email: [email protected]

www.verhuetungsmuseum.at

Upcoming ESC seminar 2005:

23-24 Sept. 2005, Warsaw, Poland

We cordially invite you to take part in the 8th ESC Seminar, which will be held in Warsaw from Friday 23 to Saturday 24 September 2005. The main aim of the Seminar is to share current practice & thoughts from around Europe and to exchange experiences during fruitful discussions, debates and forums.

The topic of the 8th Seminar is "Sexual education: the key issue of reproductive health". Four plenary presentations will introduce the main aspects of this topic.

The speakers are mostly ESC Board members from all over Europe, other experts from specific fields of contraception and reproductive health care and eminent Polish specialists.

Plenary sessions will be followed by ample discussion time and then lead into interactive workshops where the information can be added to with information from all over Europe. Each workshop will have two leaders who will co-ordinate the session and feed back the main points to the whole group during the plenary session on Saturday. These will also be written up and be available on the ESC website.

On Saturday morning, a forum will be organized with the participation of students from different Eastern European countries. This session will undoubtedly be a very valuable source of feedback with regards to sexual education in the beginning of the 21st century!

We also hope to organize one or more satellite symposia on Friday and Saturday, as well as to have a selection of free communications during the plenary sessions. Several poster sessions will be organized and posters are invited on any of the themes of the Seminar. The posters will be judged and the best awarded a prize. Deadline for abstract submission is 15 June '05 (submission instructions: http://www.contraception-esc.com/

warsaw.htm).

On Friday night you are invited to enjoy the official dinner in a folk restaurant located in the cultural center of Warsaw.

We hope that you will be joining us for an exciting seminar in a city which has a history of over 700 years. Since 1526, Warsaw is the capital city of Poland and, since that time, a major centre of rich cultural and academic life. Warsaw is waiting for you!

by Medard Lech

Organiser 8th ESC Seminar

Report of the 8th ESC congress

Once again, the European Society of Contraception held a valuable and progressive conference in Edinburgh, at which some 1,500 delegates were registered, from some 59 countries. The ‘top five’ countries were The United Kingdom, The Czech Republic, Italy, Poland and Spain. Of the 59 countries represented at the conference, nearly all the European Societies were represented and for the first time, countries as far afield as Chile sent delegates to the meeting.

The Local Organising Committee, working with the Board of ESC, introduced a number of novel ideas to the conference, which we would recommend to all future conference organisers.

We chose the theme of ‘Holism’, where we tried to draw together the different threads of the purchaser of health care, the provider of health care and the client or patient. In addition, we approached the subject of sexual health from a holistic point of view, with a multi-disciplinary programme that involved many different organisations delivering sexual health in the various European countries. The format of involving these additional professional groups was of great benefit, both in the style of presentation, the discussion and the standard of the individual sessions.

We linked the plenary sessions to the key note lectures and for the free communications, chose an entirely new style. Here, the Chairman was selected as an expert in that particular subject and gave the final ten minute presentation, summing up the state of the art and the knowledge gained from that particular session. We would recommend this style of free communication session to future conference organisers.

This conference attracted twice the number of free communication/poster abstracts, requiring assessment, and a peer-reviewed assessment process was used, leading to a very high standard of free communication, presentations and posters.

We found it helpful to use a United Kingdom Advisory Group of all those associated groups of scientists involved in the delivery of sexual health and we would like to thank their representatives for their considerable input.

The International Scientific Committee, drawn from the European Society, and the host organisation, allowed us to achieve a balanced programme, that was truly representative of sexual health delivery systems within Europe. The feedback that we have had suggests that we got the programme just about right.

I do hope the delegates will find time to join both the seminar of the European Society and the 9^th Congress of the European Society, which is to be held in Turkey from 3^rd to 6^th May, 2006, in Istanbul, Turkey – Title ‘Improving Life Quality through Contraception and Reproductive Health Care’.

by Professor John Newton

(November 2004),

on behalf of the Organising Committee, 8^th ESC Congress, EICC/Edinburgh, Scotland, 23^rd to 26^th June, 2004

(organised in association with the Faculty of Family Planning & Reproductive Health Care of the Royal College of Obstetricians and Gynaecologists)

Does anyone have an answer?

1 - What is your opinion about the reliability of OC when combined with terbanafine?

2 - Is the claim that butoconazol, contrary to other antimycotics, is a fungicide based on evidence?

From Dr Olga Loeber.

Please send answers to: [email protected]

Facts & figures - News

SpermCheck at-home male fertility tests may be available worldwide next year

05 Nov 2004 - Two new over-the-counter male fertility tests developed by a University of Virginia researcher might go on sale worldwide as early as 2005, the Richmond Times-Dispatch reports.

The tests -- which were developed by Charlottesville, Va.-based ContraVac -- work by detecting a specific sperm protein to determine a man's sperm count. A count of at least 20 million sperm per ml of semen indicates fertility, while fewer than one million sperm per ml of semen indicates infertility.

SpermCheck Vasectomy, which will be marketed to men who have had vasectomies and wish to confirm their infertility, is the more sensitive of the two tests and can detect as few as 5,000 sperm in a drop of semen. About 600,000 American men have vasectomies each year, and about four million men worldwide have the procedure annually.

(Source: http://www.medicalnewstoday.

com; 5 Nov 2004)

Call for ESC membership 2005

Dear friends and colleagues,

The ESC is an active, growing organization with members from 49 countries. Apart from our lively congresses and seminars, the Journal will captivate you several times a year and we try to keep in touch during the year through our website and Newsletter. We aim to offer you interesting news and scientific information about contraception and all the related topics.

The larger and more active our Society grows, the more essential it is to become a part of this organization. So I call upon you to become a member if you are not already, send news items and questions to the Newsletter, present your scientific data in the Journal and meet the rest of the members at Congresses and Seminars! Tell your colleagues and international contacts, send them this Newsletter and let us make this Society big and blooming.

by Olga Loeber

ESC General Secretary

Call for e-mail addresses

As we wish to reach as many newsletter readers as possible, we would appreciate receiving your (new) e-mail address, and the ones of your colleagues too.

Please mail it to:

[email protected]

- END –

Chief editor: Olga Loeber

Contributors to this newsletter: D. Cibula, M. Lech, C. Fiala, J. Newton

All materials to be included in the ESC Newsletter should be submitted (electronically) to the ESC Central Office / Ann Wattez:

[email protected]

Opalfeneweg 3, 1740 Ternat, Belgium

T. +32 2 582 08 52, F. +32 2 582 55 15

All Newsletters are also to be found on the website of the Society: http://www.contraception-esc.com