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Contraceptives for Males

Recent work regarding male contraception is reviewed and methods that may become available for general use are considered. The main methods of contraception that have been available to the male have been coitus interruptus condoms and vasectomy. The pituitary gland secretes follicle stimulating hormone (FSH) and luteinizing hormone (LH). The secretion of these hormones is stimulated by the LH-releasing hormone (LH-RH) secreted by the hypothalamus. LH carried by the blood stream to the testes stimulates production of testosterone and FSH facilitates the production of sperm. Sperm maturation occurs during their transit through the epididymis and vas. Potential male contraceptives may be effective through inhibition of FSH and LH production by the pituitary either directly or by suppression of LH-RH secretion. High doses of testosterone taken orally or by injection will suppress LH and FSH causing infertility. However these doses produce other undesirable effects. With lower dosages a 2-3 month interval is required to achieve infertility and a similar period to regain fertility after treatment. Attempts to suppress LH-RH have not been successful. A protein substance that blocks FSH secretion but not LH secretion has been extracted from testicular tissues and seminal fluids of animals but has not been available for clinical trials. Drugs acting directly on the testes to inhibit sperm formation have been accompanied by unacceptable side effects. Drugs affecting the function of the epididymis have been used in experiments on rats but in humans decreased libido and potency have been reported. The principle disadvantage of vasectomy has been the usually irreversible result. Freezing sperm or "sperm banking" has been very successful in animals but is considered unreliable at present in humans. Immunizing the male against some component of his own reproductive system has been tried but a satisfactory technique has not been developed. Presently available methods do not seem likely to be more widely used in the future. New and more efficient techniques are anticipated.