Male contraception.

Abstract

To share contraceptive measures between partners is a goal which should be reached in the future. The possibilities on the male side are still limited in comparison with the techniques available for women. During the last 20 years many efforts have been undertaken to study and evaluate possible methods for fertility control in the male, based on interaction with the hormonal axis, sperm maturation and sperm transport. The requirements for such a method in the male are the same as in female: high efficacy, little or almost no side-effects, high practicability and compliance and the possibility for easy reversibility in a high percentage of men. Despite their increasing acceptability worldwide, the existing male methods, condom and vasectomy, do not fully meet these requirements and therefore a search for alternative male methods is warranted. At present, the following medical approaches to male fertility control have been tested or are under consideration: (i) selective inhibition of FSH: antibodies, inhibin; (ii) inhibition of pituitary-gonadal axis: steroids such as testosterone, progestin-testosterone combinations, LHRH analogues with and without testosterone substitution; and (iii) selective inhibition of spermatogenesis by gossypol, a phenolic compound from cotton plant. Whether one of these methods will reach the desired goal for male fertility control has yet to be determined.