The “Future of Male Contraception” conference in Seattle last month garnered extensive newspaper and radio coverage, and a sense of optimism filled the air. About 120 laboratory and clinical investigators came together to share their most recent findings.
Here are quick summaries of noteworthy results:
- Hormonal methods continue to make progress. Researchers presented clinical trial results and several leads for a form of testosterone that would work as a pill. One study tested Depo-Provera shots plus testosterone gel, two products already on the market. Fertility return for hormonal methods is 100%, at least after up to 1 ½ years of use.
- CatSper and Adjudin researchers described the challenges they face and the directions they’re now taking their research.
- Dr. Debra Wolgemuth of Columbia University presented findings on the use of a vitamin A receptor blocker as a male contraceptive. After one week of treatment with low doses, mice were infertile. Full fertility returned within 4 months. We look forward to hearing more about this method in the future; the next step is to try various doses and study reversibility after long-term treatment.
- Dr. Sheri Hild presented a new drug known as l-CDB-4022, another drug that can be taken as a pill. This one made monkeys infertile, with full recovery by week 16. We’ll keep you up to date on this research as it progresses.
For a more detailed summary of conference news, check out the archived researcher version of this newsletter. The abstracts from the presentations and poster presentations are also available on the Future of Male Contraception website.
Dr. Chris Boelter of Shepherd Medical Company presented the much-anticipated preliminary 3-month and 6-month azoospermia numbers for the Intra Vas Device. Dr. Boelter did a good job of making clear that in this study, it took a while for sperm counts to drop near zero. So far, the IVD’s numbers are similar to numbers for a standard vasectomy: after 6 months, 92% of the men had no sperm or almost no sperm. The IVD can’t compete yet with vasectomies done by top doctors using the latest technique, which is called fascial interposition. However, the developers consider the results excellent for a first study. Based on these results, the IVD developers will seek funding for studies in Canada and further studies in the US.
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RISUG researchers have used atomic force microscopy, an extremely high-resolution imaging technology, to examine how RISUG works. As scientists gain access to these incredible new technologies, we are beginning to be able to explain contraceptives that previously seemed mysterious. The sperms’ outer layer dissolves and the contents of the acrosome leak out when sperm pass by RISUG: “Complete disintegration of the plasma membrane with subsequent rupture and dispersion of the acrosomal contents is observed on RISUG treatment.” The full publication is available in the Journal of Microscopy. If you have university access, you can see the color pictures as well.
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The fall issue of “Dialogues in Contraception” features a 5-page review article on sterilization techniques, their relative efficacies, clients’ reports of regret, and general best practices. Interestingly, the article emphasizes the heavy burden tubal sterilization places on women and urges counseling about IUDs as an alternative due to the risk of regret.
Read more
Dialogues in Contraception: Advances in Sterilization
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The current issue of “Dialogues in Contraception” also features a 4-page review article on assessing contraceptive costs and improving access. How can clinicians help patients reliably get the methods they need at a price they can afford? It concludes that “economic and structural obstacles to contraceptive access account for a large proportion of contraceptive nonuse and inconsistent use. Federal actions to enhance contraceptive equity and to increase public funding for reproductive health care would greatly improve women’s access to contraception. Nevertheless, clinicians can make an immediate positive difference by implementing strategies to expand women’s ability to obtain and successfully use effective contraception.”
The chart below, from page 6 of the report, strikingly illustrates why we need new contraceptives. When adding pregnancy costs and medical complication costs to the base cost of a method over two years, tubal sterilization gets low marks due to the high cost of its procedure — and even condoms get a middling score because of high costs from unintended pregnancies. IUDs do better, but still come in at about $1000 for 2 years; the most cost-effective method is (surprise!) vasectomy, which is unfortunately not reversible and thus not an option for many younger couples still wishing to have children. Future male methods may challenge vasectomy for the honor of “most affordable” while being reversible, and thus an option for more men and their partners.
Components of costs associated with contraceptive method use versus no method use over 2 years.*
Read more
Dialogues in Contraception: Assessing Costs and Improving Access to Contraception
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“Dialogues in Contraception” offers a variety of other informative, free Continuing Medical Education self-study courses – including the two articles described above. The website features several other CME units that may be of interest to family planning providers, including “ Improving Continuation with Various Contraceptive Methods” and “Contraceptive Methods and Sexually Transmitted Infections.” A full list of the available CMEs is available online.
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Where can you direct men who have questions about their reproductive health — or who are reluctant to discuss concerns in person? Now there is an easy-to-use website with noncommercial information on a variety of men’s issues, AndrologyAustralia.org. Andrology Australia is a unique government-funded program providing male reproductive health information and education for both members of the general public and GPs. “Downloadable fact sheets are available on line for patients and GP summary sheets are available for medical practitioners, who also have available accredited on line medical education modules.” A good site to bookmark for future reference!
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The annual American Public Health Association meeting is coming up next week in Washington, DC. If you're planning to attend, there are two sessions on men as clients of reproductive health care providers:
"Constructive Male Engagement and RH in the US" Tuesday, November 6th, 12:30-2:00 PM and
"Programs for Men: US" Wednesday, November 7th, 2:30-4:00 PM.
The APHA Men and Reproductive Health Task Force will also meet on Tuesday, November 6th from 6:00-7:00 PM . The meeting will feature a special presentation from
Men Engage, information about existing programs, and future plans. The session will be chaired by Michele Burger and Fabio Castaño; please RSVP to
Michele Burger.
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Announcements from the “Future of Male Contraception” conference garnered press coverage around the world. Here are some highlights:
AUDIO: An engaging clip on Seattle's major news-talk radio station gets the man-on-the-street's reaction to the idea of using a new method and packs in commentary from both Elaine Lissner of MCIP and Dr. Bill Bremner of the University of Washington. This 2-minute feature made the 6:00 news. Available as a podcast or for listening online!
Male Contraception
710 KIRO, 28 September
Seattle's largest daily paper featured the "Future of Male Contraception" conference in a well-researched and largely accurate article. Focuses on attitudes and hormonal approaches, but "not all researchers are putting their eggs in the hormone basket." Ends with brief mentions of the IVD (and reversibility questions), the RISUG clinical trial, and heat treatments.
Men on "the pill"? Doctors say it's no dream
Seattle Times, 27 September
Seattle's other major daily paper also featured the conference, with a focus on the University of Washington's role. "For the past two decades, researchers have tried to provide men with more choices in contraception. Women have the pill, intrauterine devices, injections, birth control patches, female condoms and the sponge. Men have basically two choices: condom or vasectomy. Although both methods work pretty well, they each have drawbacks. Many researchers say men should have more options and more of a shared responsibility..."
Breakthrough in male birth control remains elusive -- But it's only a matter of time, researchers say
Seattle Post-Intelligencer, 27 September
The University of Washington's student paper got in on the act with a front page story.
Male contraceptives coming down the pipeline
The UW Daily, September 28
LiveScience covered the highlights from the first day of the conference, working from MCIP's press release; the story then got picked up by msnbc.com (with a few inaccuracies introduced along the way). Covers the IVD, a testosterone-like drug, and a new lead that worked in monkeys.
Birth control pills for guys could be reality soon
MSNBC, 28 September
More coverage of the first day of the conference. "For decades, pundits have predicted new contraceptives for men within the next 5 to 10 years. Are we really getting any closer? Judging from work presented today at the second 'Future of Male Contraception' conference, the answer may finally be yes."
Contraception: progress brings hope for new methods for men
PHYSORG.com, 28 September
A nicely-done story based on news from the second day of the conference. Adds in statistics about unwanted pregnancies and the need in both the U.S. and abroad. Covers the new lead from Columbia University, the study of testosterone gel plus Depo-Provera from the University of Washington, and the IVD Phase I trial results. One error: it implies fertility return after IVD reversal is already known.
Conference Reveals Promising Options for Male Contraception
Associated Content, 29 September
Health Canada gives approval for the first preliminary Canadian trials of the Intra Vas Device, after the preliminary results of the U.S. Phase I clinical trial prove acceptable. This article also shows confusion on the reversibility issue.
Studies begin into reversible male contraceptive
CTV.ca, 28 September
Conference coverage reaches Ms. Magazine ’s online edition. It was the overwhelming response to a short 1992 Ms. Magazine article on the subject — over 200 letters, back in the era of envelopes and stamps — that inspired the original expansion of the Male Contraception Information Project, making this article something of a homecoming.
More Birth Control Options for Men on the Way
Ms. Magazine, 5 October
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Editors
Elaine Lissner, Director of the Male Contraception Information Project (MCIP)
Email: info@NewMaleContraception.org
MCIP is entirely nonprofit and works in three areas: raising public awareness of promising nonhormonal male contraceptives, advocating increased and expedited government research, and serving as a resource for journalists who wish to write about the subject.
Kirsten Thompson, Director of the Male Contraception Coalition (MCC)
Email: info@MaleContraceptives.org
The Coalition’s objectives are to speed the development of new male contraceptives through increased legislative and institutional support, to raise funds for applied male contraception research and development, and to educate the public about the work of the research community.
