Often the only ‘sex education’ women get is about birth control, even though that’s a privilege in a society where women’s bodies are seen through the lens of ownership and controlled by morals and traditions. Several options are laid out: the pill, vaginal rings, copper intrauterine devices, diaphragms, or female condoms to name a few. While people with testes have only two options: condoms or vasectomies. Contraception has continued to remain a women’s burden while abortion is still isn’t a choice in many countries.
The latest National Family Health Survey (NFHS-5) conducted from 2019 to 2021 on married men and women revealed that fewer than one in 10 men were using condoms, while female sterilisation remains the most popular method of contraception. Male sterilisation, which is safer and easier, remains unchanged at 0.3%, as reported by the BBC.
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However, a recent study offered hope of making birth control a more equal playing field. Earlier this month, news about a new male contraceptive pill took over the internet as the latest study published on 14 February in the journal Nature Communications by researchers from Weill Cornell Medicine, US, revealed an on-demand male contraceptive that could temporarily stop sperm from swimming towards the eggs and prevent pregnancies in preclinical models.
While research on male contraceptives has been ongoing for many decades with several false starts, this one is a “game-changer” according to the study’s co-senior authors Dr Jochen Buck and Dr Lonny Levin, professors of pharmacology at Weill Cornell Medicine.
What is the new contraceptive?
The published study provides proof-of-concept for a strategy for on-demand contraception with a focus on reducing the mobility of sperm swimming towards the eggs for fertilization. Initially, Buck and Levin didn’t set out to find a contraceptive. The latter had challenged the former to isolate soluble adenylyl cyclase (sAC), essential for sperm motility and maturation sAC, something that had not been done. Eventually, as they decided to focus on sAC, they realized that “mice genetically engineered to lack sAC are infertile,” according to the research unit’s website.
In 2018, Dr Melanie Balbach, a postdoctoral associate in their lab, discovered that mice that were given a drug that inactivates sAC produce sperm cannot move forward. An experiment conducted on mice showed that “a single dose of a sAC inhibitor called TDI-11861 immobilizes mice sperm for up to two and half hours and that the effects persist in the female reproductive tract after mating,”
Male mice treated with TDI-11861 paired with female mice exhibited normal mating behaviour but did not impregnate females in all 52 different mating attempts.
How long does the effect stay?
"Our inhibitor works within 30 minutes to an hour," Balbach said in the research unit’s article. "Every other experimental hormonal or nonhormonal male contraceptive takes weeks to bring sperm count down or render them unable to fertilize eggs."
The sAC inhibitor was 100 per cent effective in stopping sperm movement within the first two hours, dropping to 91 per cent in the first 3 hours, according to AFP. After 24 hours, the sperm moved like normal again.
Have there been attempts before?
The first clinical trial for a male birth control pill was conducted in the 1970s. It was based on using testosterone alone or in combination with progestin to suppress the production of testosterone and sperm cell development.
Every once in a while there is an article about new research on male contraceptives. However, they are usually halted and never seem to materialize. In a 2017 Bloomberg article, John Amory, a research physician at the University of Washington School of Medicine said, “The joke in the field is that the male contraceptive has been five years away for the last 40 years.”
In 2016, a clinical trial of a hormonal contraceptive injection ruled the headlines but was stopped after concerns about its side effects were raised. Although initially reported that the men couldn’t handle the effects that women using birth control pill face regularly, later it was revealed that 75 per cent of participants wanted to continue but an external panel of reviewers felt the risks outweighed the potential benefits, according to New Scientist.
The study, first published in 2012, presented a gel called NES/T (Nestorone/Testosterone) was the first male birth control product that passed the initial steps in the clinical trial process. The gel “lowers sperm production typically to less than 1 million sperm per millilitre, compared to the typical 15 to 200 million sperm per millilitre in a healthy male.”
The catch: Using Nestorone alone was not considered a good option as it inhibited testosterone production in the testes and lowered testosterone in the blood “which would reduce libido, sexual function, and other testosterone-dependent activities.” To prevent this, it also contains synthetic testosterone “to maintain blood testosterone levels in the normal range”.
This contraceptive gel is still in a trial so it’s a long way to go before it is available in pharmacies. Last year, 100 couples completed one year of the clinical trial.
How is the on-demand pill different?
The researchers hope are aiming for a single non-hormonal pill that works in under an hour and lasts 6 to 12 hours, Dr Buck told AFP. This would be different to other options that are in trials, such as the NEST/T gel which can take four to six months to fully take effect.
Susan Walker, an expert in contraception at the UK's Anglia Ruskin University, told AFP that the immediate effectiveness offered the"the possibility of seeing a sexual partner take a pill." The researchers aim to start doing the first trials on humans within three years and the rollout of the final product could be eight years away.
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