Recent developments in immunocontraception.

Abstract

The possibility of controlling fertility by antibodies inactivating key reproductive hormones has been amply demonstrated by active and passive immunization in primates. Four birth control vaccines directed against human chorionic gonadotropin are currently in early clinical trials. The nature of these vaccines and the underlying principles are described, as are the available results from clinical studies. The alpha- and beta-subunits of human chorionic gonadotropin and the ovine gonadotropins have been cloned by recombinant deoxyribonucleic acid methods. A new breed of vaccines that combines the genes of gonadotropins linked to hepatitis B surface protein has been developed. The next generation of birth control vaccines is likely to be polyvalent and to have the ability to intercept fertility at more than one point. A number of monoclonal antibodies against human sperm have shown the presence of tissue-specific antigens and the possibility of preventing the fertilization of the egg. Inclusion of more than one carrier in the vaccine increases the percentage of high responders and accords immunoprophylactic benefits against more than one disease. Conjugates have also been developed to obtain high titers of antibodies against gonadotropin-releasing hormone with permissible adjuvants. This vaccine may have therapeutic applications in hormone-dependent cancers and precocious puberty.