Male contraception

Abstract

Clear evidence shows that many men and women would welcome new male methods of contraception, but none have become available. The hormonal approach is based on suppression of gonadotropins and thus of testicular function and spermatogenesis, and has been investigated for several decades. This approach can achieve sufficient suppression of spermatogenesis for effective contraception in most men, but not all; the basis for these men responding insufficiently is unclear. Alternatively, the nonhormonal approach is based on identifying specific processes in sperm development, maturation and function. A range of targets has been identified in animal models, and targeted effectively. This approach, however, remains in the pre-clinical domain at present. There are, therefore, grounds for considering that safe, effective and reversible methods of contraception for men can be developed.

Contraception: Past, Present and Future

“…It is important to note that the vas deferens has been known to regenerate, in order to fully prevent the fallopian tubes need to be cauterized (burned) using electricity (Pollard, 2011). The failure rate is less than one percent but requires several months to achieve full contraceptive efficiency (Chao, Page, & Anderson, 2014). It should also be noted that reversal of the procedure can be costly and unreliable (Chao, Page, & Anderson, 2014).…”

“…The failure rate is less than one percent but requires several months to achieve full contraceptive efficiency (Chao, Page, & Anderson, 2014). It should also be noted that reversal of the procedure can be costly and unreliable (Chao, Page, & Anderson, 2014).…”

“…Within the last 20 years there has been a shift and a push for male contraceptives. Researchers have attempted to evaluate several methods in limiting a male's sperm count (oligospermia) or to completely cause infertility (Table 4 ) (Chao, Page, & Anderson, 2014). There have been many obstacles in producing a drug that can be fully reversible, safe for long term use, and render a male infertile (Chao et al, 2014).…”

Preventing secondary exposure to women from men applying a novel nestorone/testosterone contraceptive gel

“…However, there is no effective, reversible, and safe contraception option for men. Hormonal male contraception inhibits the hypothalamic–pituitary–gonadal axis via exogenous sex hormones to suppress endogenous testosterone (T) production, intratesticular T concentrations, and spermatogenesis while providing sufficient systemic androgens to preserve normal functions (Chao et al ., ; Wang et al ., ). With T alone, prior studies demonstrated that spermatogenesis suppression is not uniform in all men; some men did not fully respond to the dose used or escaped from suppression, despite the use of supraphysiologic doses of T (World Health Organization Task Force on Methods for the Regulation of Male Fertility, ; World Health Organization Task Force on the Regulation of Male Fertility, ; Gu et al ., ).…”

Male hormonal contraception: hope and promise

“…Allowing both men and women to share family planning responsibilities by increasing contraceptive choices would promote important, but still largely unmet individual and societal needs, such as ameliorating the number of elective terminations for unplanned pregnancies and reducing overpopulation 2 . Promising candidate non-hormonal male-directed approaches have been identified 3,4 , but pivotal trials in humans that would be necessary for drug or device registration are lacking: table 1. In contrast, more than 2000 men have already been exposed to over 2000 person-years of male hormonal contraception (MHC, consisting of androgens with or without progestins) to assess contraceptive efficacy: table 2.…”