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Human Reproduction, Vol. 9, No. 4, pp. 586-590, 1994
© 1994 European Society of Human Reproduction and Embryology

review-article

Male contraception: hormonal, mechanical and other

Frankc H. Comhaire

University Hospital Ghent, Department of Internal Medicine, Section Endocrinology, De Pintelaan 185 9000 Ghent, Belgium

Methods of male contraception that have been developed so far have mainly focused on the inhibition of spermatogenesis through suppression of the hypothalamo- pituitary secretion of gonodotrophins, and simultaneous supplementation with androgens. These methods include the use of combinations of progestogens or luteinizing hormone-releasing hormone antagonists and testosterone derivatives, or high dose testosterone. Though effective contraception can be obtained, side-effects and/or the high cost of treatment limit the widespread use of these approaches. Inhibition of sperm maturation in the epididymis, or direct interference with spermatogenic cells or the cells of Sertoli by e.g. gossypol have been abandoned because of toxic side-effects. Voluntary sterilization by vasectomy is the most commonly used method of male contraception, but its surgical nature, problematic reversibility and suspected link with subsequent prostate cancer render the method far from ideal. Non-surgical vas occlusion may overcome some of these problems, but data on long-term side-effects and reversibility are lacking. New contraceptive developments should focus on interfering with highly specific aspects of spermatogenesis such as unique enzymatic processes and intercellular communication through cytokines, or application of antibodies against antigens of the epididymis or the spermatozoa. Only through better understanding of normal and pathological spermatogenesis will it be possible to develop an acceptable male contraceptive.

Key words: androgens/contraception/LHRH analogues/male reproduction/progestins


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