**Male Contraceptives**

**Male Contraceptives**

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298 Family Planning

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Eka Rusdianto Gunardi and Yohanes Handoko Eka Rusdianto Gunardi and Yohanes Handoko Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.72163

#### **Abstract**

**Background:** The world's population has been growing exponentially, however, currently the choices for male contraception are limited. This review explores ongoing researches on male contraceptives.

DOI: 10.5772/intechopen.72163

**Method:** A literature search was conducted on PubMed, Cochrane, and Google Scholar on March 2015.

**Results:** There are 15 research done on non-hormonal male contraceptives, 2 of which are already widely used and the other 2 are undergoing clinical trials. Hormonal contraceptives are provided in two regiments, testosterone alone, and testosterone with progestins. Currently, no hormonal contraceptives are available for men.

**Conclusion:** There are a variety of possible methods for male contraception. Nonhormonal methods, such as RISUG and Gandarusa are sent through clinical trials, and may be available in the near future. There are still no hormonal contraceptives for men that are ready for use.

**Keywords:** male contraception, hormonal contraceptives, non-hormonal contraceptives

## **1. Introduction**

The world's population has been growing exponentially in the recent decades is expected to reach 9 billion in 2050. Considering the current difficulties in managing health and poverty, contraception is becoming increasingly important [1, 2].

Contraception is the intentional prevention of conception or pregnancy by various methods; barrier methods, hormonal contraception, intrauterine devices, sterilization and behavioral methods. Of these methods, only two are available for men, the male condom (barrier), and vasectomy (sterilization). The male condom is an effective method of contraception with the added benefit of prevention of STIs, however relies on discipline and availability of the

Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons

condom at the time of intercourse. A vasectomy doesn't depend on the occurrence of intercourse, but has poor reversibility rates and is therefore not ideal for men who still plan on having children [1, 3–5].

**3.2. Nonhormonal contraceptive**

tested and implemented [7].

*3.2.1. Condoms*

space for semen [7].

*3.2.2. Vasectomy*

injection [8].

been performed.

even after a period of 8 years [9].

age, and decreased pleasure for some couples [7].

*3.2.3. Reversible inhibition of sperm under guidance (RISUG)*

Nonhormonal male contraception targets sperm production, maturation and/or function, without interrupting the hormonal pathway. Many nonhormonal targets in the spermatogenesis and fertilization process has been identified, and contraceptive opportunities have been

Male Contraceptives

301

http://dx.doi.org/10.5772/intechopen.72163

Condoms prevent pregnancies by blocking the path of semen into the cervix. With correct use, the efficacy is 97%, with the added benefit of prevention against STIs and HIV. However with typical use, failure rates are as high as 12%. The correct use of condom refers to application of condom before vaginal penetration, preferably before any penile-vaginal contact. On application, the tip of the condom must be pressed to release trapped air and consequently provide

Drawbacks of this method apart from its failure rates are latex allergies, possibility of break-

Vasectomy is a procedure in which the vas deferens are divided and ligated so as to prevent flow of sperm from testis. This is an outpatient procedure, conducted with local anesthesia with minimal side effects. Following vasectomies, pregnancy rates drop to below 1%. However reversibility rates after vasectomy is less than 50%. There is no effect on libido [7].

RISUG is a method of contraception directed at destruction of sperm as it passes through the vas deferens. RISUG is applied by injection of steric maleic anhydride (SMA) and dimethyl sulfoxide (DMSO) into the vas deferens. Within the next 72 h, RISUG forms electrically charged precipitates in the lumen, with positive charges dominating [7]. This forms an acidic environment. The precipitate then layers the lumen wall, implanting themselves on the microfolds on the vas deferens' inner walls. Sperm that pass through the RISUG injected vas deferens, suffer ionic and pH stress, causing acrosomal damage, rendering them unable to fertilize oocytes [5, 8]. Studies so far have shown RISUG to be 100% effective. Because of the time needed for action, however, condom use is suggested in the first 10 days after

RISUG can be flushed out with intravasal injections of sodium bicarbonate, which will reverse its infertility effects, as has been shown in mice [9]. Reversibility testing in humans has not

There has been no serious side effect within 10 years after RISUG injections in humans. Scrotal swelling may occur after injection, but resolves on its own. A study that studied RISUG's side effects on the prostate found that there was no increased risk of developing prostatic diseases

Long term, reversible male contraceptives are currently being developed. Male contraceptives are aimed to interfere with normal spermatogenesis, or motility, orientation, and binding to ovum. This paper reviews previous studies on male contraceptives to give a general picture of the possibilities and current available methods.
