Surviving unified opposition across the religious spectrum for years and also continuing charges by critics that it gave rise to promiscuity, family breakdown, and adultery, "The Pill" - female oral contraceptive - completed its 50-year run recently. Nonetheless, the real future of birth control is men, as they can have more control over their fertility and also help women avoid the side-effects of hormonal pills. Question is when would such male contraception become a reality. It seems rather closer, given latest news from Israel and also the progress in developments initiated earlier.
The most recent news is that Israeli researcher Professor Haim Breitbart has created a compound, which can be taken as a pill that can sterilize males. The "Bright Pill" as he calls it is reversible - i.e. it will not cause permanent sterility and will only be effective for as long as it is taken.
The biochemist from Israel's Bar-Ilan University authored a breakthrough paper in 2006, describing how sperms survive in the uterus. He is taking those findings and using them against sperm, said ISRAEL21c, a non-profit educational foundation in Israel.
The "Bright Pill" is designed in such a way that it jams the reproductive ability of the sperm before it reaches the womb of the female. It works by removing a vital protein in the sperm that makes it impotent to fertilize the egg in the uterus, thereby eliminating the chances for a woman to conceive.
The new pill has been tested on mice in a pre-clinical setting. According to Breitbart, "What we found is that by treating the mice with our molecule we can get sterility for a long period of time; in the lower dose, about one month, and in the higher dose we found three months of sterility -- Later on the male mouse can become fertile. It's reversible."
A major hindrance in any kind of male contraceptive development is the lingering belief that women in general don't entrust the task of preventing pregnancy to men. However, the Israeli scientist says the "Bright Pill" needs to be taken either once every month or once every three months and further it does not impact sex drive. "I think most women would trust their man to remember once a month or once a quarter."
Talking about the side-effects, Breitbart says, "The mice behaved nicely; they ate and had sex; they were laughing, and everything, so all I can say is that we couldn't see any behavioral side-effects - all their sex behavior was retained, which is a very important consideration for human men."
Today, condoms and vasectomy (removal of the duct that carries sperms) are the only known safe and effective male contraceptives. Around the world, researchers are working on other forms of potentially safer and more effective male contraception. While these are in various stages of research and development, none are currently available. A few examples are as follows.
RISUG
Reversible inhibition of sperm under guidance (RISUG) is one of the most promising male contraceptives in development for nearly 15 years. This method involves injection of a compound (styrene maleic anhydride in the solvent dimethyl sulfoxide) to the vas deferens - the tube that carries sperms from the testes to the ejaculatory duct.
One injection of the compound partially blocks the vas deferens, and any sperm making past the block come out damaged, unable to fertilize an egg. One dose of it can provide long-lasting sterility, sometimes for up to 10 years, with none of the side effects associated with hormone-based birth control.
It has proven to be reversible in primate studies, but there have been no official reversibility tests in humans. This contraceptive has completed phase 1 and 2 clinical trials, and has moved into phase 3 trials in India in 2007, which means there is a good chance of it hitting the market soon.
Intra Vas Device (IVD)
U.S. based private equity Shepherd Medical Company has an ongoing phase 1 clinical trial to evaluate a device to determine if it is successful at blocking the sperm. The Intra Vas Device, or IVD as it is called, is a set of tiny implants that could potentially block the flow of sperm. The Lexington-headquartered company has received FDA approval in 2006 for a clinical trial to determine the effectiveness of the new IVD design.
Also, China-based Foshan Medical Company is developing an IVD design. According to Malecontraceptives.org., the Chinese design has already completed phase 2 clinical trials. The study compared the IVD to no-scalpel vasectomy, and found that the men with IVDs were more satisfied and reported fewer side effects.
Adjudin
Adjudin is another drug under development as a potential non-hormonal male contraceptive. It is an analogue of an old anticancer drug called lonidamine. A group of scientists at the Population Council of New York are developing this drug.
Adjudin works by changing the way Sertoli cells interact with sperm. Sertoli cells are the ones that divide to produce new sperm cells and then nurse the immature sperm. They remain connected to the immature sperm until it matures.
When rats were treated with Adjudin, the bridges between Sertoli cells and immature sperms broke before the sperm matured, thereby making the sperm incapable of fertilizing an egg. The effect was found reversible in rats. Adjudin was in phase 2 human trials as of May 2007. It could be at least ten years away from this drug being ready. It might not come in pill form, but rather in patch or implant.
Others
Since the 1950s, two medications, usually taken for high blood pressure and schizophrenia, were known to have properties that could make male patients sterile. In late 2006, researchers found why. They found that both the drugs freeze the muscle contractions that propel sperm through the male reproductive tract. This could result in normal sexual activity sans sperm. Efforts are underway to turn this discovery into a pill, but it still has a long way to go.
The testes are located outside the body cavity and are usually cooler than body temperature. There is anecdotal evidence that a small increase in temperature of testes results in lower spermatogenesis (the production of sperm). Multiple researchers have conducted studies on using external heat to the testes as a male contraceptive method.
Suspensories is one among the results. These are specially designed briefs that hold the testes closer to the body, thereby raising their temperature and increasing the chances of male contraception. Suspensories, in clinical trials, have found to stimulate cryptorchidism - a condition in which the testes do not descend from the abdomen, where they are originally formed before birth.
Apart from suspensories, researchers have used a variety of heat sources to disrupt male fertility, such as saunas, incandescent light bulbs, etc. There were reports recently that some scientists in North Carolina believe that even ultrasound waves can be used as male contraceptive.
Any kind of progress in developing a male contraceptive has proved to be extremely slow mainly because of the lack of interest from investors and the pharmaceutical industry as a whole. Drug manufacturers, fearing loss of market share, may not want men to know that a drug they developed for indications like heart disease or cancer has contraceptive effects, since customers may not appreciate its contraceptive properties. And generally, there is a lack of interest in the industry about male contraceptives, which makes it difficult to secure funding for further development.
Even Breitbart is seeking a $10 million investment to move on to the next stage of clinical advancement of the "Bright Pill", reports ISRAEL 21c. "If all goes according to plan, a new male birth control pill could be on the market within the next five years," Breitbart says. Let's wait hopefully.
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