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Best wishes for 2010 to all!
— Kirsten Thompson
It’s been a year since we sent out a digest of peer-reviewed research related to male contraceptive preclinical, clinical, post-market, and sociological research. Wondering where things stand? Below are the highlights of the research community’s work during 2009.
Attitudes / sociological research
Using a questionnaire and opportunistic sample of 380 adult men and women recruited in various settings in northeast England, researchers found that “although both sexes had a favorable attitude towards the male pill, females had a more positive attitude than men... Males in stable sexual relationships were more positive about the male pill than those in casual sexual relationships. Gender, relationship type and trust in the effective use of the male pill reliably predicted attitude towards the male pill... Once the male pill is widely available, promotional campaigns could target not only men but also their female partners, as the latter tend to come into contact with health services more frequently.”
Attitudes towards the male contraceptive pill in men and women in casual and stable sexual relationships.
Eberhardt J, van Wersch A, Meikle N.
J Fam Plann Reprod Health Care. 2009 Jul;35(3):161-5.
PMID: 19622206
Motility / capacitation targets
A report of two advances in CatSper research: 1) optically monitoring CatSper channel activity in intact sperm in real time, and 2) selectively and reversibly slowing CatSper ion exchange with a candidate CatSper blocker, HC-056456. “HC-056456 does not prevent activation of motility by HCO3- but does prevent the development of hyperactivated motility... When applied to hyperactivated sperm, HC-056456 causes a rapid, reversible loss of flagellar waveform asymmetry… [Open] CatSper channels and entry of external Ca2+ through them sustains hyperactivated motility. These results indicate that pharmacological targeting of the CatSper channel may impose a selective late-stage block to fertility, and that high-throughput screening with an optical reporter of CatSper channel activity may identify additional selective blockers with potential for male-directed contraception.”
Pharmacological targeting of native CatSper channels reveals a required role in maintenance of sperm hyperactivation.
Carlson AE, Burnett LA, del Camino D, Quill TA, Hille B, Chong JA, Moran MM, Babcock DF.
PLoS One. 2009 Aug 31;4(8):e6844.
PMID: 19718436
Development of improved inhibitors of the sperm-specific isoform of GAPDH has been complicated by the insolubility of the protein. “We have obtained soluble recombinant sperm GAPDH as a heterotetramer with the Escherichia coli GAPDH in a ratio of 1:3 and have solved the structure of the heterotetramer, which we believe represents a novel strategy for structure determination of an insoluble protein... [Analysis] revealed sites in the enzyme that do show significant difference compared with published somatic GAPDH structures that could be exploited by structure-based drug design to identify leads for novel male contraceptives. ”
Structure of insoluble rat sperm glyceraldehyde-3-phosphate dehydrogenase (GAPDH) via heterotetramer formation with Escherichia coli GAPDH reveals target for contraceptive design.
Frayne J, Taylor A, Cameron G, Hadfield AT.
J Biol Chem. 2009 Aug 21;284(34):22703-12. Epub 2009 Jun 19.
PMID: 19542219
Description of a novel ion exchange channel in mouse sperm, mtsNHE. This Beijing research team has cloned the protein, located it on the principal piece of the sperm flagellum, and tested polyclonal antibodies both in solution with sperm and as an immunocontraceptive in female mice. In solution, the antibodies against mtsNHE resulted in reducted motility, decreased acrosome reaction and reduced rates of in vitro fertilization. As an immunocontraceptive, it resulted in reduced fertility.
A novel testis-specific Na+/H+ exchanger is involved in sperm motility and fertility.
Liu T, Huang JC, Zuo WL, Lu CL, Chen M, Zhang XS, Li YC, Cai H, Zhou WL, Hu ZY, Gao F, Liu YX.
Front Biosci (Elite Ed). 2010 Jan 1;2:566-81.
PMID: 20036903
Two reports of the methanol sub-fraction (MSF) of Carica papapa seeds as an oral contraceptive in male rats. One report evaluated the effect of various doses (50, 100, 250 and 500 mg/kg body weight daily) over 1 year, while the other investigated in detail the effects of just the 50 mg/kg body weight dose. The highest administered dose was 10 times the contraceptive dose.
None of the treatments had significant effects on “body weight, organ weight, food and water intake or pre-terminal deaths compared to those of control animals. Sperm count and viability in 50mg/kg body weight treated animals and the weight of epididymis, seminal vesicle and prostate of all the treated animals showed significant reduction compared to control. Cauda epididymal spermatozoa of 50mg/kg body weight treated animals were immotile.” Despite azoospermia in all rats with ≥100mg/kg body doses, serum parameters, serum testosterone and histology were not different from controls.
Safety evaluation of long term oral treatment of methanol sub-fraction of the seeds of Carica papaya as a male contraceptive in albino rats.
Goyal S, Manivannan B, Ansari AS, Jain SC, Lohiya NK.
J Ethnopharmacol.. [Epub ahead of print]
PMID: 19914367
In rats treated with 50mg/kg body weight, authors observed a “reduction in nuclear and cytoplasmic volume, normal nuclear characteristics, and vacuolization in the cytoplasmic organelles of the Sertoli cells, as well as nuclear degeneration in spermatocytes and spermatids.” Leydig cells were unaffected. Sertoli cells were affected with 60 days of treatment. Spermatocytes and spermatids were affected after 120-240 days. Reduced sperm count, “total inhibition of sperm motility, increased numbers of sperm abnormalities, normal serum testosterone levels, and 100% sterility were evident after 60 days...” All effects were reversed within 120 days of cessation.
Sperm characteristics and ultrastructure of testes of rats after long-term treatment with the methanol subfraction of Carica papaya seeds.
Manivannan B, Mittal R, Goyal S, Ansari AS, Lohiya NK.
Asian J Androl. 2009 Sep;11(5):583-99. Epub 2009 Aug 3.
PMID: 19648937
Cell adhesion targets
An investigation of the Sertoli cell structure and function in retinoic acid receptor alpha-deficient mice testis. “Hypertonic fixation approaches revealed defects in the integrity of the Sertoli-cell barrier in the tubules of RARalpha-deficient testes. Dye transfer experiments further revealed that coupling between cells from the basal to adluminal compartments was aberrant. There were also differences in the expression of several known retinoic acid (RA)-responsive genes encoding structural components of tight junctions and gap junctions.”
Aberrant distribution of junctional complex components in retinoic acid receptor alpha-deficient mice.
Chung SS, Choi C, Wang X, Hallock L, Wolgemuth DJ.
Microsc Res Tech. 2009 Nov 23. [Epub ahead of print]
PMID: 19937743
“Here we investigated the lineage- and cell-specific role of RARalpha-mediated signaling during spermatogenesis using germ-cell transplantation and genetically manipulated mouse models. We demonstrated that RARalpha-deficient germ-cell stem cells were able to repopulate germ-cell-depleted wild-type testes and initiate spermatogenesis; however, improper cellular associations and abnormal sperm formation were observed. We further generated RARalpha-deficient mice that expressed RARalpha-EGFP fusion protein uniquely in haploid germ cells. Strikingly, spermatid orientation, alignment and release, as well as sperm morphology, were normal and there was a partial rescue of sterility.”
Expression of retinoic acid receptor alpha in the germline is essential for proper cellular association and spermiogenesis during spermatogenesis.
Chung SS, Wang X, Wolgemuth DJ.
Development. 2009 Jun;136(12):2091-100.
PMID: 19465599
An investigation of the oxidative status of rat testis after treatment with Adjudin. “These results show that there is an induction of oxidative stress accompanying adherens junction restructuring which suggests a role for reactive oxygen species in the regulation of these testicular junctions. However, transient elevation in reactive oxygen species levels did not affect androgen transport.”
Adjudin-mediated germ cell depletion alters the anti-oxidant status of adult rat testis.
Sarkar O, Mathur PP.
Mol Reprod Dev. 2009 Jan;76(1):31-7.
PMID: 18449895
A review of the action of adjudin and next steps for development.
Testicular cell junction: a novel target for male contraception.
Lee NP, Wong EW, Mruk DD, Cheng CY.
Curr Med Chem. 2009;16(7):906-15.
PMID: 19275601
Immunological approaches
“Various methods of vaccinology and antibody engineering have been used to obtain multi-epitope contraceptive vaccines and human single chain variable fragment (scFv) antibodies... Using phage display technology, our laboratory has synthesized in vitro at least four novel scFv antibodies with unique complementarity determining regions (CDRs) that react with specific fertility-related sperm antigens employing cDNA from immunoinfertile and vasectomized men. These antibodies inhibit human sperm function in vitro, and their immunocontraceptive effect in vivo is being investigated.”
Development of genetically engineered human sperm immunocontraceptives.
Naz RK.
J Reprod Immunol. 2009 Dec;83(1-2):145-50. Epub 2009 Oct 23.
PMID: 19853924
Three partially overlapping cDNA fragments covering the equatorial segment protein of the BALB/c mouse sperm acrosome “were cloned, expressed, and purified... Antibodies against [fragments P1 and P2] significantly reduced the rates of fertilization in vitro in the zona-intact experiments. Coincubation of zona-free mouse oocytes with capacitated mouse spermatozoa in the presence of antibodies against P1/P2 also inhibited sperm-oolemma binding and fusion.” Immunization of female mice with recombinant P1/P2 significantly decreased litter sizes.
Antifertility Characteristics of the N-terminal Region of Mouse Equatorial Segment Protein.
Lu ZM, Wang M, Xu C.
Anat Rec (Hoboken). 2009 Nov 6. [Epub ahead of print]
PMID: 19899111
“The present study has demonstrated that immunization with Bin1b peptide specifically interferes with sperm motility, resulting in a compromised fertilizing capacity of sperm... Histological studies showed no evidence of orchitis or epididymitis in Bin1b-immunized animals... Sperm recovered from the corpus epididymidis of the Bin1b-immunized animals exhibited a significant decrease in motility. Immunization of Bin1b also caused a reduction (25%) in fertility after the mating experiment.”
Immunization with Bin1b decreases sperm motility with compromised fertility in rats.
Xu W, Zhang X, Chen W, Fok KL, Rowlands DK, Chui YL, Chan HC.
Fertil Steril. 2009 Jan 7. [Epub ahead of print]
PMID: 19135192
Endocrinological approaches
A report of a randomized, unblinded clinical trial of nestorone (NES) gel in combination with testosterone gel and its effect on gonadotropin suppression in 140 healthy male volunteers. “A total of 119 subjects were compliant with gel applications with few study-related adverse events. NES alone reduced gonadotropins significantly but less than T gel alone. Combined T gel 10g plus NES gel 6 or 8 mg suppressed both serum gonadotropins (LH and FSH) to 0.5 IU/liter or less in significantly more men than either gel alone... Combined transdermal NES (6 or 8 mg) plus T gel demonstrated safe and effective suppression of gonadotropins, justifying a longer-term study of this combination for suppression of spermatogenesis.”
Combined transdermal testosterone gel and the progestin nestorone suppresses serum gonadotropins in men.
Mahabadi V, Amory JK, Swerdloff RS, Bremner WJ, Page ST, Sitruk-Ware R, Christensen PD, Kumar N, Tsong YY, Blithe D, Wang C.
J Clin Endocrinol Metab. 2009 Jul;94(7):2313-20. Epub 2009 Apr 14.
PMID: 19366848
A report of the WHO-supported multicenter, phase III, contraceptive efficacy trial of TU in China. 1,045 healthy volunteers received monthly im injections of 500mg TU in tea seed oil. “43 participants (4.8%) did not achieve azoospermia or severe oligozoospermia within the 6-month suppression phase. A total of 855 participants entered into the efficacy phase, and 733 participants completed monthly TU treatment and follow-up. There were nine pregnancies in 1554.1 person-years of exposure in the 24-month efficacy phase for a cumulative contraceptive failure rate of 1.1 per 100 men... No serious adverse events were reported. Spermatogenesis returned to the normal fertile reference range in all but two participants.”
Multicenter contraceptive efficacy trial of injectable testosterone undecanoate in Chinese men.
Gu Y, Liang X, Wu W, Liu M, Song S, Cheng L, Bo L, Xiong C, Wang X, Liu X, Peng L, Yao K.
J Clin Endocrinol Metab. 2009 Jun;94(6):1910-5. Epub 2009 Mar 17.
PMID: 19293262
Endocrinological supporting research
Could the difference in Asian and Caucasian men's rates of gonadotropin suppression under male hormonal contraceptive treatment regimens be explained by the effect of body mass on overall androgen dose? “Men showing the most rapid and consistent declines in LH and FSH levels received a slightly higher dose per body weight of TU and reached higher maximal concentrations of total T and free T as well as estradiol. Men with high fat mass had a delayed increase in T levels and an impaired relative decline in LH and FSH levels within the first 2 weeks after the first TU injection. We conclude that overweight reduces the chance of rapid and profound gonadotropin suppression during treatment with TU.”
Body fat content and testosterone pharmacokinetics determine gonadotropin suppression after intramuscular injections of testosterone preparations in normal men.
Kornmann B, Nieschlag E, Zitzmann M, Gromoll J, Simoni M, von Eckardstein S.
J Androl. 2009 Sep-Oct;30(5):602-13. Epub 2009 Apr 2.
PMID: 19342702
A report of the tissue distribution, excretion and metabolic enzymes of the synthetic androgen MENT labeled with tritium in Sprague-Dawley rats. “Specific uptake of the steroid was observed in target tissues such as ventral prostate and seminal vesicles at 6h… Liver and duodenum maintained high radioactivity throughout, as these organs were actively involved in the metabolism and excretion of most drugs... [Radioactivity] was excreted via feces and urine in equal amounts by 30h... In vitro metabolism of (3)H-MENT using rat and human liver microsomes, cytosol and recombinant cytochrome P(450) (CYP) isozymes [showed] 3 putative metabolites...”
Distribution, metabolism and excretion of a synthetic androgen 7alpha-methyl-19-nortestosterone, a potential male-contraceptive.
Prasad PV, Arumugam R, Willman M, Ge RS, Sitruk-Ware R, Kumar N.
Steroids. 2009 Jan;74(1):121-31.
PMID: 18992267
A report of the pharmacologic and contraceptive effects of the SARM S-23 plus estradiol benzoate (EB; necessary to maintain sexual behavior in rats) in male rats. “S-23 showed biphasic effects on androgenic tissues and spermatogenesis by suppressing serum concentrations of LH and FSH... In the EB + S-23 (0.1 mg/d) group, four of six animals showed no sperm in the testis and zero pregnancies (none of six) in mating trials. After termination of treatment, infertility was fully reversible, with a 100% pregnancy rate observed after 100 d of recovery… The beneficial effects of S-23 on the muscle, tissue selectivity, and favorable pharmacokinetic properties make it a strong candidate for use in oral male contraception.”
Preclinical characterization of a (S)-N-(4-cyano-3-trifluoromethyl-phenyl)-3-(3-fluoro, 4-chlorophenoxy)-2-hydroxy-2-methyl-propanamide: a selective androgen receptor modulator for hormonal male contraception.
Jones A, Chen J, Hwang DJ, Miller DD, Dalton JT.
Endocrinology. 2009 Jan;150(1):385-95.
PMID: 18772237
A testicular biopsy study exploring the mechanism of action of TU injections alone versus TU plus oral levonorgestrel (LNG). 12 healthy adult subjects participated: “1) four healthy men as controls; 2) four men 2 wk after TU treatment; and 3) four men 2 wk after TU + LNG administration... The TU treatment altered the gene expression in 109 transcripts, whereas TU + LNG altered the gene expression in 207 transcripts compared with control… In comparison with TU treatment alone, TU + LNG treatment upregulated insulin-like 6 and relaxin 1, and downregulated RNA-binding protein transcripts.”
Levonorgestrel enhances spermatogenesis suppression by testosterone with greater alteration in testicular gene expression in men.
Lue Y, Wang C, Cui Y, Wang X, Sha J, Zhou Z, Xu J, Wang C, Hikim AP, Swerdloff RS.
Biol Reprod. 2009 Mar;80(3):484-92. Epub 2008 Dec 10.
PMID: 19074003
A review of male germ cell-specific androgen receptor (AR) knockout mouse models—including peritubular myoid cells, Leydig cells, and Sertoli cells—and their effect on spermatogenesis. “This review summarizes these results as follows: 1) the impact of lacking AR in Sertoli cells mainly affects Sertoli cell functions to support and nurture germ cells, leading to spermatogenesis arrest at the diplotene primary spermatocyte stage prior to the accomplishment of first meiotic division; 2) the impact of lacking AR in Leydig cells mainly affects steroidogenic functions leading to arrest of spermatogenesis at the round spermatid stage; 3) the impact of lacking AR in the smooth muscle cells and peritubular myoid cells in mice results in similar fertility despite decreased sperm output as compared to wild-type controls; and 4) the deletion of AR gene in mouse germ cells does not affect spermatogenesis and male fertility.”
Androgen receptor roles in spermatogenesis and fertility: lessons from testicular cell-specific androgen receptor knockout mice.
Wang RS, Yeh S, Tzeng CR, Chang C.
Endocr Rev. 2009 Apr;30(2):119-32. Epub 2009 Jan 27.
PMID: 19176467
“Dienogest (DNG) plus testosterone undecanoate (TU) has the potential for development as a monthly injectable showing reversible hormonal male contraception with good efficacy... Complete arrest of spermatogenesis was observed after 60 days of treatment at all doses of DNG (20, 30 and 40 mg/kg bw per week)+TU. However, weights of testis and accessory sex organs (epididymis, prostate and seminal vesicle) declined significantly 60 days post treatment compared to vehicle-treated controls... There was no significant increase in the serum high-density lipoprotein and low-density lipoprotein levels...”
Trials for development of once-a-month injectable, hormonal male contraceptive using dienogest plus testosterone undecanoate: dose standardization, efficacy and reversibility studies in rats.
Misro MM, Chaki SP, Kaushik MC, Nandan D.
Contraception. 2009 Jun;79(6):488-97. Epub 2009 Feb 28.
PMID: 19442786
Epididymal targets
Two reviews of potential epididymal targets:
“In this review, we summarize the current knowledge of several epididymal proteins shown either in vivo or in vitro to be involved in the epididymal sperm maturation. These proteins include CRISP1, SPAG11e, DEFB126, carbonyl reductase P34H, CD52, and GPR64. In addition, we introduce novel proteinases and protease inhibitor gene families with potentially important roles in regulating the sperm maturation process. Furthermore, potential contraceptive strategies as well as delivery methods will be discussed.”
Novel epididymal proteins as targets for the development of post-testicular male contraception.
Sipilä P, Jalkanen J, Huhtaniemi IT, Poutanen M.
Reproduction. 2009 Mar;137(3):379-89. Epub 2009 Jan 8.
PMID: 19131560
Progress in the studies of human epididymal secretive proteins [Article in Chinese].
Liu BJ, Su SF, Wang ZJ, Zhang W.
Zhonghua Nan Ke Xue. 2009 Jul;15(7):646-50.
PMID: 19694383
RISUG
Reversal in rats 90 days after vas occlusion with RIUSG. “100% fertility was achieved 90 days after reversal. The fertility/pregnancy/implantation record and skeletal morphology of the offspring were comparable to control.”
Sperm characteristics and teratology in rats following vas deferens occlusion with RISUG and its reversal.
Lohiya NK, Suthar R, Khandelwal A, Goyal S, Ansari AS, Manivannan B.
Int J Androl. 2009; 33(1):198-206.
PMID: 19811546
Two laboratory studies of the polymer which partially occludes the vasa deferentia. The first is an investigation of the polymer’s properties in biological fluids with various pH and constituents to understand its retention in the vas deferens. The second is a report of a novel RISUG preparation containing iron oxide and copper and its in vitro effects on rat sperm.
Polyelectrolyte polymer properties in relation to male contraceptive RISUG action.
Roy S, Ghosh D, Guha SK.
Colloids Surf B Biointerfaces. 2009 Feb 15;69(1):77-84.
PMID: 19111447
Smart RISUG: a potential new contraceptive and its magnetic field-mediated sperm interaction.
Jha RK, Jha PK, Guha SK.
Int J Nanomedicine. 2009;4:55-64. Epub 2009 Apr 1.
PMID: 19421370
Mechanical approaches
Alpha(1)-blockers are widely used to treat benign prostatic hyperplasia. “Several studies reveal that in elderly patients the alpha(1A)-selective antagonist tamsulosin can induce a notably high incidence of ejaculation dysfunction characterized by low ejaculate volume. Recent clinical trials suggest that tamsulosin may effectively inhibit sperm ejaculation in young volunteers. Since alpha(1A)-adrenoceptor subtype plays a dominant role in mediating the contractions of accessory sex organs contributing to ejaculation, we hypothesize that blockade of alpha(1A)-adrenoceptor may suppress the motility of these organs, thereby inhibiting sperm transport and achieving contraception, and the alpha(1A)-selective antagonists can act as a male contraceptive.”
Blockade of alpha 1A-adrenoceptor: a novel possible strategy for male contraception.
Chen Y, Li H, Dong Q, Wang KJ.
Med Hypotheses. 2009 Aug;73(2):140-1. Epub 2009 May 8.
PMID: 19427736
Proteomic / genomic supporting research
“The spermatozoon is a transcriptionally and translationally suppressed cell that is released from the testes in a functionally inert state. Functional activation occurs in the epididymis and female tract via mechanisms that are entirely dependent on post-translational modifications. Proteomics is, therefore, the ideal technology to investigate this cell type. Herein, we comment on the proteomic analyses that have been applied to mammalian spermatozoa, including some concerns relating to data interpretation.”
Proteomic insights into spermatozoa: critiques, comments and concerns.
Baker MA, Aitken RJ.
Expert Rev Proteomics. 2009 Dec;6(6):691-705.
PMID: 19929613
A summary of the findings regarding the involvement of the 26S proteasome in fertilization: “(1) proteasomes are present in the mammalian sperm acrosome and on the acrosomal surface… (3) proteasomal proteolytic and ubiquitin-deconjugating (deubiquitinating) activities can be detected in viable, motile mammalian spermatozoa; (4) proteasomes remain associated with the sperm head following ZP-induced acrosomal exocytosis; (5) inhibition of ubiquitination and proteasomal proteolysis blocks fertilization… (6) inhibition of proteasomal proteolysis alters the course of mammalian sperm capacitation and acrosomal exocytosis… (8) inhibition of proteasomal proteolysis blocks sperm-ZP penetration, but does not alter the rate of sperm-ZP binding in mammals...“
The sperm proteasome during sperm capacitation and fertilization.
Zimmerman S, Sutovsky P.
J Reprod Immunol. 2009 Dec;83(1-2):19-25. Epub 2009 Oct 22.
PMID: 19853307
An update to the 2004 article which identified “93 genes whose deletion demonstrated an effect on fertility in male mice... In the present article, we found 71 additional gene knockouts in the database… which demonstrated an effect on male fertility… The knockouts of only a few genes/proteins induced a specific effect on fertility without a serious side effect. These genes/proteins may provide novel targets for contraception/contraceptive vaccine development.”
Gene knockouts that affect male fertility: novel targets for contraception.
Naz RK, Engle A, None R.
Front Biosci. 2009 Jan 1;14:3994-4007.
PMID: 19273329
A review of “recent evidence for the identification and characterization of molecular markers of sperm functions with emphasis on post-ejaculatory maturation events and the process of sperm-oocyte interaction.”
Molecular markers of human sperm functions.
Muratori M, Luconi M, Marchiani S, Forti G, Baldi E.
Int J Androl. 2009 Feb;32(1):25-45. Epub 2008 Feb 20.
PMID: 18298567
“A number of miRNAs are expressed abundantly in male germ cells throughout spermatogenesis, while piRNAs are only present in pachytene spermatocytes and round spermatids. In this review, we first address the synthesis, mechanisms of action, and functions of siRNA, miRNA, and piRNA, and then we focus on the recent advancements in defining the small RNAs in the regulation of spermatogenesis.”
Small RNA molecules in the regulation of spermatogenesis.
He Z, Kokkinaki M, Pant D, Gallicano GI, Dym M.
Reproduction. 2009 Jun;137(6):901-11. Epub 2009 Mar 24.
PMID: 19318589
Vasectomy
Over 500,000 vasectomies are performed in the US each year. Researchers used nationally representative data to explore disparities in the utilization of vasectomy. About “14.1% of white men had a vasectomy, [while] only 3.7% of black and 4.5% of Hispanic men” did. Taking into account demographic, partner, and socioeconomic factors, Black and Hispanic men still had significantly lower odds of vasectomy. “Having ever been married, fathering 2 or more children, older age, and higher income were factors associated with vasectomy… Further research is needed to identify the reasons for these race/ethnic differences and to identify factors that impede minority men's reliance on this means of fertility control.”
Racial differences in vasectomy utilization in the United States: data from the national survey of family growth.
Eisenberg ML, Henderson JT, Amory JK, Smith JF, Walsh TJ.
Urology. 2009 Nov;74(5):1020-4. Epub 2009 Sep 20.
PMID: 19773036
Using the same data as the analysis above, another group “examined the association between race/ethnicity and receipt of sterilization counseling.” Only 1.7% of men 15-44 had received counseling about vasectomy. “Although counseling was reported more commonly by Black and Hispanic men compared with White men, the rates were not significantly different... [There] were exceedingly low rates of sterilization counseling for all men regardless of race/ethnicity.”
Low Rates of Vasectomy Among Minorities: A Result of Differential Receipt of Counseling?
Borrero S, Moore C, Creinin M, Ibrahim S.
Am J Mens Health. 2009 Aug 25. [Epub ahead of print]
PMID: 19706674
Editor
Kirsten Thompson, Director of the Male Contraception Coalition (MCC)
Email: Kirsten@MaleContraceptives.org
Phone: +1 (443) 858-1183
With assistance from the Male Contraception Information Project (MCIP)
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