METHOD OF CONTRACEPTION AND APPARATUS FOR CARRYING OUT SUCH METHOD

Abstract: A non-surgical method of contraception is described which provided for the insertion of an expansible plug (12) through the female reproductive tract into the oviduct. When so positioned, the plug (12) is expanded into sealing contact with the oviduct wall. In turn, the plug can be subsequently collapsed and withdrawn when the contraceptive effect is no longer desired. For carrying out the method, a positioning device (32) is releasably connected to the plug (12) to facilitate its insertion and positioning and cooperating means (24) (26) (30) (34) (40) (42), electrical or mechanical, in the plug (12) and positioning device (32) enable control of plug expansion and/or collapse from the exterior of the female body by the attending physician.

Description: The present invention relates generally to contraceptive techniques and, more particularly, to a method of contraception and apparatus for carrying out such method A large nunber of contraceptive techniques have been developed. Mile-utilized condoms and femaleutilized diaphragms have been employed for many years but are notably inconvenient and none too effective. Birth control pills are quite effective but have certain adverse side effects that limit their utilization. Intrauterine devices (I.U.D.s) are also generally effective but present problems such as accidental eMbedding in the uterine wall requiring surgical removal. More recently, devices have been inserted into the ovidco s to block or occlude the tube, but, in many cases, require surgical implantation and removal (laparotony). In short, all reversible contraceptive techniques, in spite of much development effort, have presented many and varied problems. It is therefore an object of the present invention to provide a contraceptive method which involves the non-surgical implantation or positioning of a tubal occlusion device in the femaae oviduct in a manner which assures effective contraception but at the same time enables simple withdrawal of the device when desired. According to the invention, there is provided a tubal occlusion device which comprises a plug composed of expansible material and arranged to assume an initial laterally collapsed disposition less than the interior diameter of the tube, and means within said plug adapted for actuation to effect lateral expansion of said plug into sealing contact with the walls of the tube. The tubal occlusion device preferably takes the form of a hollow expansible plug which can be inserted through the ferralereprottuctive tract including the vagina, the uterus, and the narrow and convoluted intramural portion of the oviduct into the isthmic ampullary junction. Since both the intramural and isthmic portions of the oviduct are quite small (e.g. l#1-4 mn. in diameter) the occlusion device preferably takes the form of a thin elongated cylinder in its collapsed disposition having a diameter no greater than one millimeter to facilitate passage into the oviduct. Once properly positioned, the plug is expanded to provide sealing contact with the wall of the oviduct thus effectively preventing conception Subsequently, if plug removal is desired, in accordance with an additional aspect of the invention, the hollow plug can be collapsed to its thin configuration to allow simple withdrawal. Therefore, according to a further aspect, the invention provides contraceptive apparatus which comprises an expansible hollow plug, an elongated positioning device, means for releasably connecting the ends of said plug and said positioning device, and means cooperatively arranged in said plug and said positioning device for effecting collapse and/or expansion of said plug. The invention also provides the method of contraception which comprises the steps of positioning an expansible plug in the female oviduct-, and expanding the plug into sealing contact with the wall of the oviduct. For carrying out the method, the contraceptive apparatus is employed which, as mentioned, includes the plug that is hollow and has a collapsed and expanded configuration. Preferably the plug is formed by silicone rubber or other resilient material having no adverse interaction in its contact with the oviduct. In its collapsed form, it takes the form of a narrow elongated cylinder that can easily pass into the oviduct. moans are provided to effect expansion of the plug laterally outward into sealing contact with the oviduct walls. Preferably such expanded configuration is in the form of a bellows-like structure whose ridges engage and press the walls of the oviduct outwardly. This not only assures sealing contact therewith but also provides frictional engagement effectively precluding longitudinal shifting or dislodgement of the expanded plug in the oviduct. Such expansion means is a cooperative arrangement in the plug and a positioning device which can be releasably attached to the plug and is sufficiently elongated so as to pass to the exterior of the female for access by the attending physician. In certain embodiments of the invention, the positioning device is arranged not only to enable implantation of the occlusion plug but also, when desired, enable simple collapse and subsequent withdrawal thereof. In one embodiment of the invention, the plug is in the form of a hollow bellows composed of silicone rubber closed at its outer or distal end and sealed at its inner proximal end by a connector enabling releasable connection to an elongated positioning device which the physician can manipulate to enable insertion and positioning within the female oviduct. To tacilitate such insertion, a length of shape memory metal, such as that known under the tradename Nitinol, is positioned in extended generally rectilinear configuration within the hollow plug to deform the same into a lengthened and narrowed disposition. After insertion to the desired position within the oviduct, heat is applied to the shape memory metal which effects contraction thereof longitudinally into a generally helical configuration to effect expansion of the plug laterally into its bellow configuration to effect sealing contact with the walls of the oviduct. Preferably, the heat is generated by passing electric current through the shape memory metal in an amount sufficient to reach its transition temperature and thus effect contraction of the memory metal. The positioning device can then be released from its connection to the plug, which latter will then remain in its laterally expanded and sealing contact with the walls of the oviduct. A second slightly modified embodiment of the invention facilitates removal of the rubber plug when desired. This embodiment also includes a hollow bellows-like plug formed of silicone rubber closed at its outer distal end and connected at its inner proximal end to a suitable connector which enables releasable connection to an elongated positioning device. Electrical connections are made from a suitable source to a Nitinol loop within the hollow plug so that when current is applied to heat the Nitinol, it will assume its shape memory position which is an elongated one which essentially narrows the plug dimensions to facilitate insertion into the oviduct. This elongated disposition of the Nitinol acts in opposition to a thin coil spring which tends to contract and thus acts in opposition to the force exerted by the Nitinol elongation. When the applied heat is removed, such coil spring is sufficiently strong to contract and thus force the hollow plug into its bellows-like configuration wherein sealing contact is made with the oviduct. The positioning device can then be released leaving the plug in its contraceptive position within the oviduct. However, when removal is desired, the positioning device can be again connected by the physician to the proximal end of the plug and current applied to heat the Nitinol and thus extend the same, the force of extension of the Nitinol to its memory shape position being substantially greater than that of the coil spring so that once again the Nitinol is extended and the surrounding silicone rubber returned to its collapsed disposition which obviously will facilitate removal of the plug when the contraceptive effect is no longer desired. In another embodiment of the invention, a mechanical expansion means is employed. More particularly, the occlusive device is normally in the form of ç hollow bellows-type structure formed of silicone rubber with its outer distal end closed and its inner proximal end sealingly connected to a flexible reservoir also preferably formed by silicone rubber. In its normal position, the plug takes a thin elongated configuration to facilitate insertion into the oviduct. However, the positioning device includes means-which encompasses the reservoir and can be actuated to squeeze -the same thus to force fluid therefrom into the plug itself and accordingly expand the plug into a bellows configuration to provide sealing contact with the oviduct. The squeezing of the reservoir can then be released but the expanded configuration of the plug itself is retained through utilization of a releasable check valve located between the reservoir and the plug itself. The plug forming the occlusion device is thus left in its position until removal of the plug is desired. When such removal is desired, the positioning device is once again inserted into encompassing relationship with the reservoir and a mechanism at its inner extremity can be actuated to open the releasable check valve so that the pressure within the plug is released and will return to its narrow cylindrical configuration so that plug removal is facilitated. In a further embodiment of the invention, a hollow silicone rubber plug is again employed but is arranged to move from its collapsed to expanded disposition in a substantially different manner. More particularly, within the hollow plug, a #mall hollow conduit is positioned and is provided at spaced intervals with lateral openings. Between these openings, annular sealing members are connected between the central conduit and the exterior plug and a conventional septum is provided at the inner end -of the hollow plug which again is closed at its outer extremity. When the plug or occlusion device is to be inserted, a positioning device is releasably connected thereto and includes a central hypodermic-needle secured at the extremity of a positioning device and which is arranged to penetrate the septum and after initial insertion and positioning of the plug in a narrow elongated cylindrical form, fluid, hydraulic or pneumatic, can be injected through the needle into the central conduit and its lateral openings so as to expand the silicone rubber plug into a bellows-like configuration so as to seal the. oviduct. The positioning device can then be removed and the septum will maintain the plug in its expanded contraceptive position. Subsequently, if the plug is to be removed, the positioning device can again be repositioned with the central needle extending through the septum and with no application of exterior pressure the resiliency of the silicone rubber plug will cause it to collapse into its elongated cylindrical configuration and enable the ready removal of the plug through a simple manual pull on the connecting end of the positioning device. The stated objective of the invention and the manner in which it is achieved as summarized hereinabove will be more readily understood by reference ot the following detailed description of the exemplary struct#ures shown in the#accompanying drawings wherein: Fig. l is -a diagrammatic sectional view of the female reproductive tract indicating insertion of a tubal occlusion device in accordance with the present invention, Fig. 2 is an enlarged fragmentary perspective view of the occlusion device of Fig. 1, Fig. 3 is a perspective view, similar to Fig. 2, but showing the occlusion device in its expanded disposition and the positioning device separated therefrom,# Fig. 4 is a fragmentary perspective view of a modified occlusion device in its collapsed disposition with its po#sitioning device attached, Fig. 5 is a view similar to Fig. 4 with the occlusion device in its expanded disposition, Fig. 6 is a fragmentary perspective view similar to Fig. 2 and 4 of a modified embodiment of the invention with the occlusion device in its collapsed disposition, Fig. 7 is a view similar to Fig. 6 showing the occlusion unit in its expanded disposition, Fig. Fig. 8 is a view similar to Figs. 2, 4 and 6 of a further modified embodiment with the occlusion device in its collapsed disposition, and Fig. Fig. 9 is a view similar to Fig. 8 with the occlusion device in its expanded configuration. With initial reference to Fg. 1 there is illustrated in a sectional showing the reproductive tract of the female including the vaginal channel V, the cervix C, the uterus U and the oyiduct or fallopian tubes 0. In accordance with the present invention, an elongated positioning device 10 with the tubal occlusion device 12 detachably mounted at its extremity has been passed upwardly through the female reproductive tract until the occlusion device itself is positioned in the medial portion of the oviduct.0. As shown generally in Fig. l and enlarged perspective in Fig. 2, the tubal occlusion device 12 is in the form of a hollow plug 20 of silicone rubber which is shown in its longitudinally-extended and laterally-collapsed disposition wherein its diameter is in the neighborhood of 1 millimeter which facilitates implantation of the plug 20 into the oviduct 0 which, as previously mentioned, has a diameter in the range of 1 millimeter to 4 millimeters. The outer extremity of the plug 20 is closed by a rounded enclosing tip 22 which also helps to guide the plug into the oviduct when it is inserted by the physician. In turn, the inner end of the hollow plug 20 is sealingly secured to one end of a cylindrical plastic insulated connector 24 also of a very narrow diameter and having two electrodes 26, 28 at spaced positions along its length. These electrodes 26, 28 are joined to the two extremities of a wire loop 30 which is electrically insulated along its length and is formed by thin conductive Nitinol wire which, as shown in Fig. 2, is in substantially a lengthened rectilinear disposition which stretches the silicone rubber plug 20 longitudinally so as to laterally effect collapsing of the same into the previously mentioned thin extended disposition with its outer end connected to the tip 22. The Nitinol wire loop 30 is mechanically. deformed to this thin elongated substantially rectilinear configuration at a temperature below its transition temperature in its martensitic phase. However, if the Nitinol is then heated to a temperatu#re above its transition temperature so as to reach its austenitic phase, in accordance with its unique shape memory characteristics, it will automatically deform itself into its preset configuration# which in the present instance as best shown in Fig. 3 constitutes a foreshortened and widened helical coil which in turn effects foreshortening of the surrounding silicone rubber plug into a bellows-like configuration whose ridges provide periodic contact with the surrounding walls of the oviduct 0 thus to provide an effective seal and also frictional engagement to preclude movement of the plug along the oviduct channel. With regard to the Nitinol material itself, details of its characteristics can be found in a NASA publication SP5110 entitled, "55 Nitinol, The Alloy with a Memory; Its Physical Metallurgy, Properties, and Applications" (1972). Briefly, for present purposes, if the Nitinol' is a binary# compound having between 50.0 and 50.2 percent of Nickel, with the balance being Titanium, the transition temperature would be in the range of 50 to 55 degrees Celsius or 122 toy131 degrees Fahrenheit so that the material can be readily heated to its transition temperature without having any adverse effect on the contacted portions of the reproductive tract. It is to be particularly noted even though the wire is slightly heated above body temperature to provide the transition, it is also enclosed within the silicone rubber so that direct heated contact with the oviduct is not required. It should be additionally mentioned that since 50 degrees Celsius is above normal ambient temperatures, accidental expansion of the plug is avoided. The positioning device, as shown in Fig. 1, is an elongated hollow plastic tube 32 having limited flexibility and a length sufficient so that the plug 20 which is releasably connected to its end can be positioned within the oviduct under control of the physician at a position exterior of the female body Releasable mechanical connection is made with the connector 24 at the end of the plug 20 by a split-coaxial connector 34 formed by two semi- cylindrical spring fingers also preferably formed by plastic material. The spring action will cause the split fingers to engage the connector 24 at the end of the plug but a conical wedge actuator 36 positioned at the inner end of the coaxial fingers can be pulled by an attached stainless wire puller 38 which extends beyond the end of the positioning tube 32 so that a manual pull by the physician will spread the fingers and allow the connection to the connector end of the plug 20 to be released. On the interior of the coaxial fingers, electrical contacts 40, 42 are formed at longitudinally-scaced positions so that when the connection with the connector end of the plug is made, the electrodes 26, 28 are engaged so that electrical current supplied from a suitable source indicated at 44 through thin wires 46, 48 within the positioning tube can be energized to--effect heating of the Nitinol loop 30 so that it will be heated above its transition temperature and, the wire loop will move from its elongated Fig. 2 position to the helically-coiled and-foreshortened disposition of Fig. 3 and, in turn, the surrounding silicone rubber plug 20 will be foreshortened and laterally expanded into contact with the oviduct 0 as shown clearly in Fig. 3. The physician can at this time pull the wire to spread the coaxial fingers of the coaxial connector 34 whereupon the entire positioning device 10 can be withdrawn. The Nitinol loop 30 will retain its coil-like configuration (Fig. 3) so that the silicone rubber plug 20 remains in secure sealing contact with the surrounding walls of the oviduct thus precluding conception. With reference to Figs. 4 and 5, a slightly modified embodiment of the invention is illustrated. More particularly, the plug 50 is in the form of a hollow tube of silicone rubber which is movable between an extended thin rectilinear disposition shown in Fig. 4 and a laterally expanded bellows-like configuration wherein sealing contact is made with the walls of the oviduct O in a manner similar to that shown in Fig. 1. Within the hollow plug, a loop 52 of Nitinolds again exposed but is arranged so that upon heating above its transition temperature, the loop will attain the longitudinally-extended disposition shown in Fig. 4 which will, in turn, cause the surrounding silicone rubber plug to assume a narrowed elongated disposition as shown in that same Figure. Such elongation of the Nitinol loop 52 and the surrounding plug 50 is opposed by a stainless steel coil spring 54 also positioned within the plug whose strength is insufficient to overcome the elongation of the Nitinol loop 52 when heat is applied thereto. However, after heat is removed, it has sufficient strength to overcome the Nitinol elongation and thus force the plug to# a foreshortened disposition which, as indicated clearly in Fig. 5, expands the plug 50 into its bellows-like configuration wherein sealing contact with the walls of the oviduct are again established. To provide for heating of the Nitinol, the loop 52 is connected at its extremities to spaced contacts 56, 58 on a ball connector 60 formed of plastic insulating material which is capable of receptipn within a split spring socket 62 mounted at the end of a positioning tube 64 generally of the same configuration as that described in Fig. 1. The spring socket 62 may be opened by pulling on a wire 66 extending through the positioning tube 64 so as to effect a pull on a wedge-like actuator 68 that opens the socket portion enabling release from the ball connector 60 of the plug 50. The interior of the split socket also includes spaced metallic contacts 70, 72 that enable electrical connection to the contacts 56, 58 on the ball when engagement therewith has been achieved through wires 74, 76 extending through the tube to a power source (not shown) under control 'of the physician as in the first embodiment. In this embodiment of the invention, the end of the positioning' device 64 is releasably connected through the ball and socket arrangement described and current is supplied therethrough to the Nitinol to extend it to its Fig. 4 disposition enabling insertion into the oviduct. The electrical source is then disconnected which allows the stainless coil spring 54 to act in a foreshortening manner within the plug 50 so that it attains the bellows-like configuration shown in Fig. 5 whereupon the positioning device can be removed leaving the plug in its contraceptive disposition. However, it should be noted that if the plug 50 is to be removed for any reason, the positioning device 64 can again be connected to the end thereof and current applied which will supply sufficient heating of the Nitinol to again extend it to its Fig. 4 position so that ready removal of the plug 50 from the oviduct is enabled. While the described embodiments of the invention both utilized Nitinol and electrical heating thereof, it will be apparent to those skilled in the art that other forms of heating can be used, direct conductive heating of the Nitinol, inductive heating or many other alternatives. Furthermore, other means can be provided to expand or collapse the tubal occlusion device without the use of hitindl and, more particularly, with a simple mechanical activation. By way of example, reference is made to Figs. 6 and 7 where a simple hydraulic arrangement is utilized. As shown in Fig. 6, the device includes again-a hollow cylindrical plug 80 in its co#la1#sed disposition having a relatively thin elongated disposition with a closed rounded tip 82, the same being formed by silicone rubber of similar material having a predetermined resiliency and the characteristic of not interacting adversely with the walls of the oviduct in which it is again implanted in the manner generally shown in Fig. 1. The inner end of the silicone rubber plug 80 is connected through a releasable one-way valve 84 to a closed hydraulic reservoir 86 also composed of flexible material which normally is just in one-way fluid contact with the plug itself. The reservoir 8,6 is filled with some hydraulic fluid 88 and-if pressure is applied to such reservoir the fluid will be delivered through the one-way valve 84 into the plug 80 so as to exert interior pressure which expands the plug into its laterally-expanded, bellows-like configuration as shown in Fig. 7. To exert this pressure, an elongated positioning tube 90 includes resilient squeezer tips 92 at its inner end that can be moved into encompassing relationship with the reservoir 86 and thence through the release of a wedge actuator 94 connected to a wire 96 encompassed within the positioning plastic tube be released so that the spring squeezer tips 92 will move inwardly into the position shown in Fig. 6 so as to eject the fluid 88 through the one-way valve 84 intosthe occlusion plug 80 to expand the same into its bellows-like configuration where sealing of the oviduct passage is accomplished. In turn, if the plug 80 is to be collapsed to enable removal, another positioning tube 98 as shown in Fig. i-can be positioned over the reservoir with the spring fingers 100 encompassing the one-way valve 84. When a wedge actuator 102 is released, the one-way valve is opened whereupon the inherent resiliency of the silicone rubber tube 80 will exhaust the fluid back into the flexible reservoir 86 thus to reduce the lateral dimensions of the plug into the Fig. 6 disposition whereby ready withdrawal can be achieved. Yet another mechanical fluid unit is illustrated in Figs. 8 and 9 wherein again a hollow plug 110 is formed by silicone rubber of a hollow configuration which normally will reside in a narrow elongated disposition such as shown in Fig. 8 with the outer end of the silicone rubber plug closed and a central conduit 112 positioned therewithin that is sealed to the surrounding silicone rubber at longitudinal intervals by annular partitions 114. Between such partitions, the conduit 112 has lateral openings 116 which enable fluid connection between the annular space between the partitions and a source of hydraulic fluid. The inner or proximal end of the plug 110 is closed by a septum 118 which can be penetrated by a hypodermic needle 120 secured to the end of a conduit 122 within a positioning tube 124 of the type generally described ip connection with the-previous embodiments of the invention so that fluid, liquid or gaseous can be injected from the exterior of the female through the needle 120 into the central conduit 112 so as to expand the silicone rubber to the bellows-like configuration shown in Fig. 9. Split encompassing spring members 126, 128 connected to the end of the positioning tube 124 surround the hypodermic needle and allow connection to the portion of the plug 110 surrounding the septum to enable the initial positioning and also to subsequently enable positioning of the needle through the septum when removal of the plug is desired. In such, case, the inherent resiliency of the silicone rubber will force the fluid therewithin out of the plug 110 and if necessary, a vacuum connection (not shown) can be made to the exterior end of the hypodermic needle to accelerate withdrawal of fluid from the plug and its collapse to the disposition shown in Fig. 8 whereby easy withdrawal of the occlusion plug can be achieved.

Claims: CLAIN 1. A tubal occlusion device which comprises a plug composed of expansible material and arranged to assume an initial laterally collapsed disposition less than the interior diameter of the tube, and means within said plug adapted for actuation to effect lateral expansion of said plug into-sealing contact with the walls of the tube. 2. A tubal occlusion device according to claim 1 wherein said plug in its collapsed disposition assumes an elongated generally cylindrical configuration and in its expanded state assumes a foreshortene'd'bellows configuration. 3. A tubal occlusion device accordi#ng to claim 1 wherein said plug is hollow. ' rs; 8, 4. A tubal occlusion device according to claim 3 wherein said plug is composed of resilient material. 5. A tubal occlusion device according to claim 4 wherein said plug is composed of silicone rubber. 6. A tubal occlusion device according to claim 4 wherein said plug is adapted upon de-actuation to reassume automatically its collapsed disposition. 7. A tubal occlusion device according to claim 4 wherein said hollow resilient plug is arranged to receive fluid under pressure to effect expansion thereof.. 8. A tubal occlusion device according t6' claim '/'w'frich '6om'prises a central conduit extending through said hollow resilient plug alld having lony itudin#1 1 ly-spaccd, lateral openings in its wall, and a plurality of annular partitions connecting said central conduit intermediate its openings to the interior wall of said .hollow# plug, said central conduit being adapted for connection at one end to a source of fluid. 9. A tubal occlusion device according to claim 8 which comprises valve means adjacent the end of said conduit for controlling communication with the fluid ,source.- 0. A tubal occlusion device according to claim 4 which comprises an enclosed resilient reservoir communicating with one end of said plug and containing a fluid adapted upon application of exterior compressive forces to effect expansion of said plug into its expanded configuration. 1. A tubal occlusion device according to claim 3 which comprises a member composed of shape-memory material extending centrally through said hollow plug to normally hold said plug in its laterallycollapsed.disposition, but adapted upon the application of heat thereto to effect lateral expansion of said plug into its expanded disposition. 2. A tubal occlusion device according to claim 11 wherein said shape-memory material is Nitinol. 13. A tubal occlusion device according to claim 11 wherein ! said shape-memory material is electrically conductive, and which comprises means connected to said material and adapted to connect the same to an external source of electrical power to toeffect heating thereof. 14. A tubal occlusion device according to claim 13 wherein said hollow plug is composed of electrically non-conductive material. 15. A tubal occlusion device according to claim 3 which comprises a member composed of shape-memory material adapted upon application of heat to-move said plug to its collapsed disposition, and spring means automatically operative upon removal of heat to effect lateral expansion of said plug. ii6. Contraceptive apparatus which comprises an expansible hollow plug, an an elongated positioning device,# I means for releasably connecting the ends of said plug and said positioning device, and means cooperatively arranged in said plug and said positioning device for effecting collapse and/or expansion of said plug. i7. Contraceptive' apparatus according to claim 16 wherein ; said connecting means includes spring means for establishing the releasable connection and manually operable means for releasing the connection. 1,18. Contraceptive apparatus according to claim 17 wherein said cooperative means includes a conductive loop of shape-memory material in said plug, a source of Ii electrical power, and means for supplying current from said source to said shape-memory loop. ii j19. Contraceptive apparatus according to claim 16 wherein said cooperative means includes means for introducing fluid into said hollow plug. 20. The method of contraception which comprises the steps of positioning an expansible, plug in the female oviduct, and expanding the plug into sealing contact with the wall of the oviduct. 21. The method of contraception according to claim 20 which comprises the the additional step of collapsing the plug when removal is is desired. 22. The method of contraception according to claim 20 which comprises the initial step of inserting the plug through the female reproductive tract into the oviduct. 123. The method of contraception according to claim 22 which Ii comprises.the additional step of releasably connecting the plug to an elongated positioning device enabling insertion or removal of the plug.

Inventors: HODGSON, DAREL E., KRUMME, JOHN F., MCADAMS, RONALD E.
Applicants: BETA PHASE INC.
Application year: 1983
Main classification: A61F5
IPC codes: A61F6