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Current Status of Male Contraception Dey D Review Article Current Status of Male Contraception Dey D. *1, Chatterjee A. 2, D. Banji 2 and Bhowmik B.B.3 1Pukhraj Health Care Pvt. Ltd, Jalandhar, Punjab-144022, India. 2Department of Industrial Pharmacy,Nalanda College of Pharmacy, Charlapally, Hyderabad Road, Nalgonda-508001,Andhra Pradesh, India 3Himalayan Pharmacy Institute, Majhitar, East Sikkim, 737132 ABSTRACT Rapid Population growth has caused a serious problem in economic growth and human development in the developing countries like India. The control of human fertility, in the sense of its limitation is the most important and urgent one, amongst all bio-social and Address for actuarial problems, confronting mankind today. Methods and Correspondence intentions, typically termed for birth control are generally considered a pivotal ingredient to family planning. Male Contraception is one of Pukhraj Health Care the promising answers to the above problems perhaps. The Pvt. Ltd, Jalandhar, development of male contraceptive is relatively newer concept, Punjab-144022, India. researched or reviewed so far. Mechanism of male contraception, different methods and different intelligent drug delivery systems and E-mail: possible novel drug delivery system (NDDS) are reviewed in this dip_mpharm@ article. yahoo.co.in Keywords : Male contraception, Mechanisms, Advanced drug delivery systems, Herbal microcapsules. INTRODUCTION The developments of male oral contraceptives for women. Likewise, contraceptives represent relatively novel vasectomies are very effective but few men method of contraception. Male involvement are willing to undergo the surgery. 1 in the field of contraception has been low. Human sperm is optimally produced The limited work on male contraception at a temperature that is a few degrees below may be due to cultural background, social body temperature. Infertility is induced if and economic condition, indifference and the temperature of the testes is elevated. For poor understanding of factors controlling this reason, men trying to conceive are often male fertility. The only method available to encouraged to avoid wearing snugly-fitting men is still those that were available during undergarments. The thermal suspensory the first half of the century, namely method of male contraception utilizes Condom, Vasectomy, Withdrawal etc. specially designed suspensory briefs to use While prophylactic condoms provide good natural body heat or externally applied heat barrier protection from unwanted to suppress spermatogenesis. Such briefs pregnancies but they are not as effective as hold the testes close to the body during the American Journal of Phytomedicine and Clinical Therapeutics www.ajpct.org Dey et al___________________________________________________ ISSN 2321 – 2748 day, ideally near the inguinal canal where (iv) prevention of sperm deposition. local body heat is optimum. Sometimes this method is also called artificial cryptorchidism, as it is simulates the (i) Agents for Suppression of infertility in men with undescended Spermatogenesis testicles. 2 The ability of an androgen-alone Drug therapy is also being evaluated modality to induce and maintain azoospermia as a potential form of male contraception. was evaluated in a multicentre contraceptive Many drugs have been investigated in male efficacy study carried out by WHO, using contraception. One such drug, Nifedipine, is weekly injections of 200 mg of testosterone thought to induce sterility by blocking enanthate (TE), as a prototype androgen. The calcium channels of sperm cell membranes results showed that the cumulative lifetable to which results in cholesterol deposition and achieve azoospermia was only 64.5%. 5 The membrane instability of the sperm, inability of an androgen-alone regimen to rendering them incapable of fertilization. induce and maintain uniform azoospermia Herbal preparations have also been was evident even when testosterone buciclate used as male contraceptives. Gossypol, a (TB) was used. 6 TB, when administered to constituent of cottonseed oil, was found to short-term castrated rhesus monkeys be an effective and reliable male exhibited a pharmacokinetic profile, which contraceptive in very large-scale was superior to that induced by TE. These experiments conducted in China. Most studies clearly indicated the need for caution recently, a form of sugar that sperm interact in using relatively short-acting androgens like with in the fertilization process has been TE for male contraception. 7 isolated from the outer coating of human eggs. (ii) Combination Regimens Perhaps one of the most researched In progestogen – androgen methods of male contraception using drugs combination regimes, smaller doses of involves the use of hormones. Like female androgens are needed, compared to androgen- contraceptive pills, Male Hormone only modality, since androgen potentiates the Contraceptives (MHCs) seek to stop the antispermatogenic activity of the progestogen, production of sperm by stopping the which acts as the primary antispermatogenic production of hormones that direct the agent in the regimen. Effective suppression of development of sperm. 3 spermatogenesis could be achieved only by use of a potent and long-acting progestogen MECHANISM OF ACTIONS OF MALE like depot medroxyprogesterone acetate. It CONTRACEPTIVES 4 would be worthwhile to initiate studies in Indian men, since this would make available a Current researches in India to develop viable contraceptive option for use in family a male contraceptive are directed mainly planning programmes in India. 8 towards: (I) development of antispermatogenic agents (iii) Follicle-Stimulating Hormone to suppress sperm production, Suppression (ii) prevention of sperm maturation, While a role for follicle-stimulating (iii) prevention of sperm transport through vas hormone (FSH) in the maintenance of deferens (or rendering these sperm infertile) spermatogenesis was well known, details of and its site of action were shown. These studies AJPCT1[3][2013]282-290 Dey et al___________________________________________________ ISSN 2321 – 2748 carried out at the Indian Institute of Science, by Guha and colleagues at the Indian Institute Bangalore showed that FSH deprivation by of Technology. 11 immunoneutralization significantly reduced the proliferation of spermatogonial cells and a marked inhibition in the transformation of (v) Prevention of Sperm Deposition 12 spermatogonia to primary spermatocytes. 9 Barrier methods like use of condoms have Another study showed that immunizing dual effectiveness, viz. prevention of sperm bonnet monkeys with recombinant FSH deposition in the female tract and prevention receptor protein affected testicular function of transmission of STDs and HIV. The and fertility. contraceptive prevalence of condom in India is an insignificant 31% (NFHS 1998–99). (iv) Inhibition of Sperm Maturation Recently, scientists and experts agreed that to With the development of new increase use of condoms four major issues andrology techniques like subzonal needed to be addressed: insemination of sperm and intracytoplasmic • changing norms about sexual behavior sperm injection, the relevance of the and condom use, epididymis in sperm maturation has come • assuring effective use, under increasing doubt. A role for epididymis • providing greater access to condoms, in sperm maturation was established in • changing restrictive policies concerning nonhuman primates and in humans at the All condoms. India Institute of Medical Sciences. These studies evaluated changes in sperm motility DIFFERENT METHODS OF MALE and its hormonal dependence, changes in CONTRACEPTION sperm ultrastructure and reorganization of Emerging approaches to male lipid bilayer and changes in lectin binding to contraception can be broadly classified into 10 sperm. As an extension of the above two groups. One direction does not directly studies, sperm surface proteins undergoing affect spermatozoa production and early maturational changes were identified. These stages of development, but subsequently, studies clearly showed the occurrence of during passage in the epididymis and the vas modification in sperm surface epididymal difference, the functional character is altered glycoproteins during maturation. and the number passing on the ejaculatory duct reduced. There is thus the possibility of (iv) Prevention of Sperm Transport localized intervention with virtually no This is essentially a vas deferens systemic effect. The second class of method based approach. Vasectomy has been in use aims to suppress spermatozoa production since many decades as a terminal method to generally by manipulating the hormonal prevent sperm transport; intra- and extra-vasal status. Moreover, there is a requirement of non-occlusive methods have been developed regular intake of drugs orally or by injection. in India. Two major approaches have been Different methods of male contraception are attempted in India to prevent sperm transport shown in Fig.1. through the vas deferens. These are use of intravasal copper by Kapur and colleagues at (i) Natural Method the All India Institute of Medical Sciences, Withdrawal method (coitus and injection of a non-sclerosing agent, interruptus) and periodical abstinence styrene maleic anhydride (SMA) into the vas particularly in mid-cycle are the only two natural methods of contraception for males. AJPCT1[3][2013]282-290 Dey et al___________________________________________________ ISSN 2321 – 2748 Although discouraged and rightly so, by In the first large scale efficacy trial
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