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Related Experiment Video

Updated: May 9, 2026

The Polyvinyl Alcohol Sponge Model Implantation
06:23

The Polyvinyl Alcohol Sponge Model Implantation

Published on: April 18, 2012

Sponge versus diaphragm for contraception.

Maureen A Kuyoh1, Cathy Toroitich-Ruto, David A Grimes

  • 1Public Health, independent, Nairobi, Kenya.

The Cochrane Database of Systematic Reviews
|July 20, 2013
PubMed
Summary
This summary is machine-generated.

The contraceptive sponge is less effective and has higher discontinuation rates than the diaphragm. More research is needed on spermicide side effects and STI prevention.

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Area of Science:

  • Reproductive Health
  • Contraception
  • Clinical Trials

Background:

  • The contraceptive sponge, a polyurethane device impregnated with nonoxynol-9, offers a spermicide alternative to the diaphragm.
  • Unlike the diaphragm, the sponge allows multiple acts of intercourse within 24 hours without additional spermicide and does not require fitting or a prescription.

Purpose of the Study:

  • To compare the efficacy and continuation rates of the contraceptive sponge versus the diaphragm when used with nonoxynol-9.
  • To test the hypothesis that the sponge would exhibit higher failure and discontinuation rates compared to the diaphragm.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials comparing the vaginal contraceptive sponge with diaphragms used with nonoxynol-9.
  • Searches conducted across multiple databases including MEDLINE, POPLINE, LILACS, CENTRAL, ClinicalTrials.gov, ICTRP, and EMBASE.
  • Methodological quality assessed using Cochrane guidelines; Peto odds ratios calculated for pregnancy and discontinuation.

Main Results:

  • Two trials met inclusion criteria, indicating the sponge was significantly less effective than the diaphragm in preventing pregnancy.
  • 12-month cumulative pregnancy rates per 100 women were higher for the sponge (17.4 in the US trial, 24.5 in the UK trial) compared to the diaphragm (12.8 in the US trial, 10.9 in the UK trial).
  • Discontinuation rates at 12 months were also higher with the sponge (Odds ratio 1.31; 95% CI 1.07 to 1.59), with more allergic reactions reported.

Conclusions:

  • The contraceptive sponge demonstrates lower efficacy in pregnancy prevention and higher discontinuation rates compared to the diaphragm.
  • Further randomized controlled trials are necessary to investigate the role of spermicides in preventing sexually transmitted infections and their potential adverse effects.