Happy holidays and best wishes for 2009 to all!
— Kirsten Thompson and Elaine Lissner
Dr. Debra Wolgemuth and her Columbia University team submitted a grant in response to the RFA in May on New Approaches to Male Contraception and will be one of about 8 labs being funded as part of a U01 consortium. Congratulations! Next item on Dr. Wolgemuth’s wish list: funding for a primate efficacy study.
An additional 2 RISUG study sites have opened, bringing the total to 6 of the planned 10. Congratulations! Next on our RISUG wish list: publication of the results of a follow-up study of Phase II trial volunteers. Preliminary analysis shows no intact sperm in any of the subjects, who have been using RISUG for 5 - 7 years.
Currently there are about 1.8 million young people under 15 on the planet, with another 40 being added every minute. How many of them will have a new contraceptive option? The answer depends on consistently supporting male contraceptive leads, including these, as they move through the pipeline!
This month brings to an end both the year 2008 and regular monthly Male Contraception Update newsletters. We’ve come to this decision for two main reasons: first, we’ve accomplished a substantial amount of what we set out to do; and second, we are both ready for new horizons and new challenges.
A personal note from Elaine Lissner, director of the Male Contraception Information Project:
When I founded MCIP, my goals were to alert the public to the promising but maddeningly neglected research in male contraception; help men and women convince policymakers of the urgency of demand; and get new nonhormonal male contraceptives to market.
Well, two out of three are done! With radio pieces, articles everywhere from Time to Newsweek to the BBC, and even an appearance on the Geraldo Rivera show, most people now say “I’ve heard something about that!” instead of “Huh?!?” or “Men would never use that!” when you tell them about male contraception. And policymakers have responded admirably to the public’s petitions and sometimes vehemently-expressed desire, stepping up efforts and making development of new male contraceptive options a top priority.
From the start, my passions were RISUG (the 10-year shot), ultrasound (potentially 10-15 minutes of non-invasive testicular waves for 6 months of contraception), and the never-destined-to-be-popular DIY heat methods. Now I come to a place where my activism and awareness-raising work on these methods is largely done, and each method must stand or fall based on its own scientific merits (and its developers’ diligence, rigor, and savvy). Money is available for both RISUG and ultrasound research if they are ready to receive it, and there is not much more I can do wearing an activist hat.
However, there is more I can do, and have been able to do recently, wearing a new hat. Through a new involvement in the foundation world, funding has been found to put Dr. Fahim’s 1970’s and 1980’s ultrasound research to the test by seeing if can be duplicated by a respected research team. Results should be available in 2009.
RISUG research, for its part, requires patience. Additional sites are being opened one by one for the ongoing Phase III clinical trial in India. And when the Indian government publishes results of its followup study (of men in the previous trial) and conducts a planned reversibility study, foundations will be eager to join in moving this method forward. These publications are necessary data, because reversal in humans is key to making this method appealing to the several billion men worldwide who are not finished having children or ready for vasectomy. RISUG reversal (and repeated reversal after re-injection) has been published in monkeys, but not in humans.
That leaves the third goal un-achieved: actually getting a new method to market. But this will be a matter of many people working together for many years, and I think we’re well on the way.
As I begin to focus less on male contraception public advocacy, I will continue moving these methods forward through involvement in the foundation world. And my passion will be directed towards one additional new area: new nonsurgical sterilization methods for humane dog and cat population control, an area which has been revitalized and energized recently.
One of the promising nonsurgical methods is not appropriate for men because it reduces testosterone, but one, non-invasive vas deferens occlusion by high-intensity focused ultrasound (HIFU), should be useful for men as well, as a non-invasive alternative to vasectomy. (In fact, it should be even easier to develop successfully for men, because of anatomical differences.)
I am grateful for all the wonderful contacts I have made and inspiring colleagues I have met in my 13 years working on male contraceptive development, and I would not be making this transition if I were not certain that we will continue to work together.
A personal note from Kirsten Thompson, director of the Male Contraception Coalition and MaleContraceptives.org:
I began this work in 1999, when I found Elaine Lissner’s 1994 overview paper on novel male contraceptive methods. My curiosity led me to update her research with the help of the National Library of Medicine. I decided to share what I’d learned via a website, MaleContraceptives.org. The response was amazing – men and women from all over the world wrote to me, asking when they would be able to use the new methods described on the site. This outpouring of public interest catalyzed all the advocacy work that followed, including channeling the public’s energy into letter-writing campaigns and surveys.
The recently completed MaleContraceptives.org survey shows that men and women who are actively seeking new contraceptive options are at increased risk of unintended pregnancy. They are 2-4 times more likely than the national average to use the least effective birth control methods – natural family planning, withdrawal and condoms. The need for new male methods is as salient now as it was 10 years ago.
Much has changed in those 10 years. The scope of male contraceptive research has broadened, communication about these methods has improved, and the broader reproductive health community has put male involvement on its agenda.
- The andrology community has grown and incorporated new research methodologies
- Male contraceptive researchers network with each other at the NICHD/WHO/CONRAD “Future of Male Contraception” conferences
- New male contraceptives have been covered by the New York Times, the US News and World Report, CNN, and other major media outlets
- While USAID has reduced its role in contraceptive development, the Bill & Melinda Gates Foundation has added contraceptive development to its reproductive health grantmaking agenda
So, the public has sought out this information; we have helped the public convey their enthusiasm to policymakers; policymakers have responded; and researchers are talking to each other and staying aware of each others’ work. I wish I could say that a new method had been introduced, but that will come with time if we continue on this course. I am confident that with the dedicated leadership of the Population Council, the NICHD staff and others, the field will continue on the path of increased networking, communication, and collaboration.
Meanwhile, new opportunities and challenges await me. In addition to my male contraceptive advocacy work, I am now occupied fulltime as the coordinator of the Long-Acting Reversible Contraception project at the University of California, San Francisco. The project aims to explore barriers to the use of highly effective and lasting methods, such as progestin implants and the progestin and copper IUDs. Despite their effectiveness, convenience, and popularity in other countries, these methods are used by few US women. This project is a wonderful match for my passions: helping couples make informed choices about their reproductive health, and ensuring access for all couples to as many family planning methods as possible.
I am grateful for the opportunity to have worked with this community of inspiring scientists and policymakers. Your collective work is undoubtedly making a difference. I look forward to the continued crossing of our paths in the small world of contraceptive and reproductive health research.
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Looking for the latest on a particular method? Trying to find a paper you read, you don’t remember where? Take a look through the past Male Contraception Update newsletters, all archived for you at IMCCoalition.org/newsletter.
We’ll be in the process of updating the MCIP and MaleContraceptives.org sites over the next several months. Until the update is complete, the newsletters are the place to find the most up-to-date information. They summarize three years of peer-reviewed male contraceptive research publications, and categorize the research subjects for your convenience.
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Editors
Kirsten Thompson, Director of the Male Contraception Coalition (MCC)
Email: Kirsten@MaleContraceptives.org
Phone: +1 (443) 858-1183
Elaine Lissner, Director of the Male Contraception Information Project (MCIP)
Email: Lissner@NewMaleContraception.org
Phone: +1 (415) 839-6304
