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Human Reproduction, Vol. 17, No. 11, 2869-2877, November 2002
© 2002 European Society of Human Reproduction and Embryology

Investigation of hormonal male contraception in African men: suppression of spermatogenesis by oral desogestrel with depot testosterone

R.A. Anderson1,5, Z.M. van der Spuy2, O.A. Dada3, S.K. Tregoning2, P.M. Zinn2, O.A. Adeniji3, T.A. Fakoya3, K.B. Smith4 and D.T. Baird4

1 MRC Human Reproductive Sciences Unit, Centre for Reproductive Biology, Edinburgh EH16 4SB, Scotland, 2 Department of Obstetrics and Gynaecology, University of Cape Town, South Africa 7925, 3 Centre for Research in Reproductive Health, Sagamu, Nigeria and 4 Division of Reproductive Science and Development, Centre for Reproductive Biology, University of Edinburgh, Edinburgh EH16 4SB, Scotland

BACKGROUND: Suppression of spermatogenesis to azoospermia is required for effective hormonal male contraception, but the degree of suppression varies between ethnic groups. We here report the first study of hormonal suppression of spermatogenesis in two African centres using a regimen of oral progestogen with depot testosterone. METHODS A total of 31 healthy men (21 black) were recruited in Cape Town and 21 men in Sagamu, Nigeria. Subjects were randomized to take either 150 or 300 µg desogestrel daily p.o. with testosterone pellets. In Cape Town, desogestrel was administered for 24 weeks with 400 mg testosterone re-administered 12 weekly. In Sagamu, desogestrel was administered for 52 weeks with 200 mg testosterone (later increased to 400 mg) re-administered 12-weekly. RESULTS: In Cape Town, 22 men completed at least 20 weeks treatment. Azoospermia was achieved in 8/10 and 8/12 men in the 150 µg and 300 µg desogestrel groups. Four men in Sagamu withdrew. Azoospermia was achieved in all 17 men in the two groups. There were no significant changes in lipoprotein or haemoglobin concentrations in any group. CONCLUSION: These data demonstrate that the combination of oral desogestrel with depot testosterone is an effective regimen for suppression of spermatogenesis in African as in Caucasian and Chinese men, with azoospermia achieved in a total of 83/98 (85%) men.

Key words: depot testosterone/desogestrol/male contraception/spermatogenesis

5 To whom correspondence should be addressed. E-mail: r.a.anderson{at}hrsu.mrc.ac.uk


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