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Asian Journal of Andrology. 1999 Jun; 1:7-12.The aim was to present a personal account of the involvement of the World Health Organization (WHO) in the collaborative development in Asia of those areas of andrology concerned with male contraception and reproductive health. The andrology training through workshops and institution support undertaken by the WHO Human Reproduction Programme (HRP) and how they contributed to the strengthening of andrology research in Asia are summarised. The author's experience and the Asian scientific contributions to the global research in the following areas are reviewed: the safety of vasectomy and the development of new methods of vas occlusion; gossypol and its failure to become a safe, reversible male antifertility drug; Tripterygium and whether its pure extracts will pass through the appropriate toxicology and phased clinical studies to become acceptable contraceptive drugs; hormonal methods of contraception for men. The WHO policy of research capacity building through training and institution strengthening, together with the collaboration of Asian andrologists, has created strong National institutions now able to direct their own programmes of research in clinical and scientific andrology. (author's)
In: Annual technical report, 1992, [of the] World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction. Geneva, Switzerland, WHO, 1993. 63-78. (WHO/HRP/ATR/92/93)This document contains the 1992 Annual Report of the Task Force on [the development of safe, effective, reversible, and acceptable] Methods for the Regulation of Male Fertility of the World Health Organization's Special Programme of Research, Development, and Research Training in Human Reproduction. In the area of hormonal methods, the Task Force is currently concentrating its research activities on 1) the evaluation of the functional capacity of sperm produced by men who have been suppressed to severe oligozoospermia, 2) the development of testosterone buciclate as an injectable method and as replacement therapy for hypogonadal men, and 3) the development of second generation progestogens and new gonadotrophin-releasing hormone antagonists as gonadotrophin suppressing agents. The safety and acceptability of hormonal methods for men remain a concern and topic of research activities. As an alternative to hormonal methods, the Task Force is continuing its search for a drug with a reversible, post-testicular action on the normal function of sperm stored in the epididymis. An ideal preparation would be quickly effective and quickly reversible. Collaborative studies in China also continue to investigate the antifertility action of pure compounds isolated from the plant species Tripterygium wilfordii. During 1992, the Task Force also continued its support of studies on three methods of vas occlusion: the no-scalpel method, a chemical sterilization method, and the polyurethane-plug. The efficacy and reversibility of silicone vas occlusion also remains under study. A training workshop on vas occlusion methods was attended by 32 participants in Indonesia in April 1992, and the safety of vasectomy continues to be monitored by the Task Force. This report notes the state of research on inhibin isolated from porcine follicular fluid and on the possibility of an immunization approach based on a vaccine against follicle-stimulating hormone. Two projects supported in 1992 sought to identify sperm surface proteins as putative immunogens. The report ends by recounting its investigator initiatives, its collaborative research programs, and its efforts in the area of information distribution. A summary describes 10 areas in which substantial progress was made during 1992.
Association for Voluntary Sterilization - Consultant Team. Trip report: the People's Republic of China, Beijing, Chongqing, Wuhan, Guangzhou, June 19-30, 1985.
[Unpublished] 1985. 41,  p.The Association for Voluntary Sterilization consultant team visited Beijing, Chongqing, Wuhan and Guangzhou, China in June 1985, to review innovative nonsurgical methods of male and female sterilization. There are 2 variations on vasectomy, performed with special clamps that obviate a surgical incision. The 1st is a circular clamp for grasping the vas through the skin, and the 2nd is a small, curved, sharp hemostat for puncturing the skin and the vas sheath, used for ligation. Vas occlusion with 0.02 ml of a solution of phenol and cyanoacrylate has been performed on 500,000 men since 1972. The procedure is done under local anesthesia, and is controlled by injecting red and blue dye on contralateral sides. If urine is not brown, vasectomy by ligature is performed. The wound is closed with gauze only. Semen analysis is not done, but patients are advised to use contraception for the 1st 10 ejaculations. Pregnancy rates after vasectomy by percutaneous injection were reported as 0 in 5 groups of several hundred men each, 11.4% in 1 group and 2.4% in another group. The total complication rate after vasectomy by clamping was 1.8% in 121,000 men. 422 medical school graduates with surgical training have been certified in this vasectomy method. Chinese men are pleased with this method because it avoids surgery by knife, and asepsis, anesthesia and counseling are excellent. Female sterilization by blind transcervical delivery of a phenol-quinacrine mixture has been done on 200,000 women since 1970 by research teams in Guangzhou and Shanghai. A metal cannula is inserted into the tubal opening, tested for position by an injection of saline, and 0.1-0.12 ml of sclerosing solution is instilled. Correct placement is verified by x-ray, an IUD is inserted, and after 3 months a repeat hysteroscopy is done to test uterine pressure. Pregnancy rates have been 1-2.5%, generally in the 1st 2 years. Although this technique is tedious, requiring great skill and patient cooperation, it can be mastered by paramedicals. The WHO is assisting the Chinese on setting up large studies on safety and effectiveness, as well as toxicology studies needed, to export the methods to other countries.
In: Sciarra, J.J., Markland, C. and Speidel, J.J., eds. Control of male fertility. (Proceedings of a Workshop on the Control of Male Fertility, San Francisco, June 19-21, 1974). Hagerstown, Maryland, Harper and Row, 1975. p. 274-307Literature on research approaches to permanent and relatively reversible methods of male fertility control is reviewed. Sources and expenditures for research into male fertility control are noted. Permanent methods discussed include electrocautery of the vas, transcutaneous interruption of the vas, vasectomy clips, chemical occlusion of the vas, and passive immunization. Reversible methods reviewed include vasovasotomy, intravasal plugs, and vas valves. Current research into animal models, reversibility after vas occlusion, nonocclusive surgical techniques, pharmacological alteration of male reproductive function, including adrenergic blocking agents, steroidal compounds, inhibitors of gonadotropin secretion, clomiphene citrate, organosiloxanes, prostaglandins, alpha-chlorohydrin, heterocyclic agents, and alkylating agents, and delivery systems for antifertility agents is discussed. Research into semen storage and improved condoms is also reviewed. As a relatively low proportion of funds are committed to research in male fertility control, a greater investment in applied and clinical research is warranted.