Published-Ahead-of-Print December 27, 2006, DOI:10.2164/jandrol.106.002386
Journal of Andrology, Vol. 28, No. 3, May/June 2007
Copyright © American Society of Andrology
DOI: 10.2164/jandrol.106.002386
Perspectives and Editorials
MATTHEW P. HARDY AND
PETER N. SCHLEGEL
Male contraception has been limited to use of the condom and vasectomy. The
challenge of developing a new male contraceptive has loomed as a goal in the
field of andrology for many years. In 1990, the World Health Organization
released the results of the first multicenter clinical trials of a hormonal
contraceptive regimenweekly intramuscular injections of 200 mg
testosterone enanthatethat caused azoospermia in 60% of the men tested
after 120 days. At the time, it was a much debated topic whether complete
azospermia, zero sperm in the ejaculate, was a necessary standard for
effective fertility regulation, given that suppression of conceptive
efficiency exceeds 95% when sperm concentrations in the ejaculate fall below 3
million sperm/mL.
The World Health Organization disbanded its Task Force on Male
Contraception in 1990, leaving the research community without a central forum
to analyze and discuss results and consider new contraceptive development.
Beginning in 1997, a group of clinical and basic researchers began holding an
annual summit meeting to explore options to accelerate the pace of drug
discovery and testing in this area. Today, hormonal contraception is the only
new male method close to the market place, although much work remains to
improve the formulations and delivery of the steroids that are its active
agents. In 2006, at the most recent 10th Summit Meeting on Hormonal Male
Contraception in New York, a set of guidelines was drafted and released to
provide benchmarks for future development and testing of hormonal methods. In
this issue, we are reprinting the Guidelines. We note that suppression to less
than 1 million sperm/mL, not azospermia, was set as the recommended standard.
The debate over this issue has been addressed, and the field of male
contraceptive development has progressed.