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CONTRACEPTION. 1980 Feb; 21(2):121-34.A 7-country WHO (World Health Organization) field trial on hormonal drugs for males administered either by daily pill or monthly injection, is being undertaken. The trials, being conducted in Hong Kong, Bangkok, London, Mexico City, Santiago, Seoul, and Toronto, provide an opportunity to assess acceptability and effects on sexuality of these new male contraceptives. The research uses repeated interviews over a 15-month period, conducted by social and biomedical scientists. The respondents are asked to compare their evaluation of the method with previously-used male or female methods and to indicate whether they feel the method modified or interfered with sexual desire, feelings, and/or performance. Methodology of the trials is explained. The hormones used, numbers of volunteers participating, and other factors important for each trial site are tabulated. Preliminary results are available from some of the trial sites The new method, either pill or injectable, was ranked highest as to acceptability, followed by vasectomy and condoms. Respondents favored self-administered, reversible methods. In fact, irreversibility was found to be the most negative feature of vasectomy, indicating that a reversible form of sterilization would be acceptable. Respondents in all trial sites favored 3-month injectables the most and permanent methods the least. Effectiveness and ease of use were important in a contraceptive.
NETWORK. 1992 Aug; 13(1):20-3.Researchers are pursuing 2 approaches to developing a male contraceptive drug. 1 approach centers around suppression of sperm production the other around blocking conception. Researchers are looking at introducing hormonal contraceptives into men's bodies via injections or implants to stop sperm production. Both forms of these possible male contraceptives will not be available for many years, however. A WHO study on testosterone enanthate of men in 7 countries reveals total suppression of sperm production occurred in almost all the Asian men, but only about 60% suppression occurred in other ethnic groups. A current WHO study is examining whether a hormonal contraceptive which is not 100% effective can be useful if it would be more effective than barrier methods. The Population Council is conducting research on 2 capsule implants with 1 capsule releasing luteinizing hormone releasing hormone 13 to halt sperm production while the other releases an androgen to maintain sex drive. Animal tests indicate complete contraception with no side effects. The other possible means of suppressing sperm production is administration of a cottonseed oil extract called gossypol which appears to stop sperm production thereby eliminating the need for concurrent androgen administration. Yet it does cause potassium depletion in some men which can result in arrhythmias. An antifertility vaccine comprises the 2nd approach. Several US researchers are exploring an antifertility vaccine to produce antibodies only to the specialized sperm surface needed to attach to the egg. The 1st antifertility vaccine would probably be in pill form and a woman's contraceptive since it is earlier to target the smaller number of sperm in the oviduct than in the testes.
MEDICAL JOURNAL OF AUSTRALIA. 1991 Feb 18; 154(4):230-3.The 1st published study of efficacy of a hormonal male contraceptive, by the WHO Special Programme of Research, Development and Research Training in Human Reproduction, employed weekly deep intramuscular injections of testosterone enanthate. 271 fertile married men at 10 centers worldwide participated for 18 months. The goal of this preliminary study was to determine if azoospermia was necessary or sufficient for effective contraception. Azoospermia was produced in 157 men, who then participated in a 12-month trial. There was 1 pregnancy, for a failure rate of 0.8 per 100 person-years, highly effective in comparison with oral contraceptives, IUDs and injectables. There was a 12% annual discontinuation rate reasons cited were acne (4%), behavioral effects such as aggression or increased libido (1%), and other medical reasons (1%), e.g. weight gain, polycythemia, hyperlipidemia or hypertension. Recruitment of study subjects was difficult in developed countries until direct public appeals met with success. Future developments in the male hormonal contraceptive field will require a more acceptable administration route. To develop this, longer-acting injectables or implants utilizing testosterone cybutanate (20AET-1), or other combinations of testosterone with a progestin or a gonadotropin-releasing hormone antagonist are envisioned. The effect of incomplete azoospermia and the fertilizing capacity of remaining sperm is a serious issue for research. Each more crucial is resolution of the social, political and legal problems involved in male hormonal contraceptive research. Probably reform of the US product liability litigation procedures will do more to advance contraceptive development than any other single factor.