Human Reproduction, Vol. 17, No. 6, 1490-1501,
June 2002
© 2002 European Society of Human Reproduction and Embryology
Oral desogestrel with testosterone pellets induces consistent suppression of spermatogenesis to azoospermia in both Caucasian and Chinese men
1 Department of Obstetrics and Gynaecology, Centre for Reproductive Biology, University of Edinburgh, Edinburgh, 2 Shanghai Institute of Family Planning Technical Instruction, Shanghai, People's Republic of China, 3 Drug Control Centre, King's College London and 4 MRC Human Reproductive Sciences Unit, Centre for Reproductive Biology, 37 Chalmers Street, Edinburgh EH3 9ET, UK
BACKGROUND: Effective hormonal male contraception requires a high prevalence of spermatogenic suppression, which has proved particularly difficult in Caucasian populations. We have investigated the combination of oral desogestrel with depot testosterone in Caucasian and Chinese men. METHOD: Thirty men in Edinburgh and 36 men in Shanghai received 150 or 300 µg desogestrel p.o. daily for 24 weeks with 400 mg testosterone pellets s.c. on day 1 and at 12 weeks. RESULTS: Eight men withdrew before completing 24 weeks treatment. Testosterone concentrations remained within the normal range. Spermatogenesis was profoundly suppressed in all men. Azoospermia was achieved by a higher proportion of men in the 300 µg desogestrel group: 28/28 men versus 22/31 men (P < 0.05). All Caucasian men in the 150 µg group achieved sperm concentrations of <1x106/ml whereas three men in the Shanghai group maintained sperm concentrations of >3x106/ml. Fifteen men continued on this regimen for a subsequent 24 weeks: all remained azoospermic for the duration of treatment. High-density lipoprotein cholesterol fell by 15% in Caucasian men, but was unchanged in the Chinese men; both groups showed some weight gain. CONCLUSION: This combination of oral desogestrel with depot testosterone maintains physiological testosterone concentrations with consistent suppression of spermatogenesis to azoospermia in both Caucasian and Chinese men and therefore has many of the properties necessary for a contraceptive preparation for men.
Key words: desogestrel/male contraception/progestogen/spermatogenesis/testosterone
5 To whom correspondence should be addressed. E-mail: r.a.anderson{at}hrsu.mrc.ac.uk
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