To share contraceptive measures between partners is a goal which should be reached in the future. The possibilities on the male side are still limited in comparison with the techniques available for women. During the last 20 years many efforts have been undertaken to study and evaluate possible methods for fertility control in the male, based on interaction with the hormonal axis, sperm maturation and sperm transport. The requirements for such a method in the male are the same as in female: high efficacy, little or almost no side-effects, high practicability and compliance and the possibility for easy reversibility in a high percentage of men. Despite their increasing acceptability worldwide, the existing male methods, condom and vasectomy, do not fully meet these requirements and therefore a search for alternative male methods is warranted. At present, the following medical approaches to male fertility control have been tested or are under consideration: (i) selective inhibition of FSH: antibodies, inhibin; (ii) inhibition of pituitary-gonadal axis: steroids such as testosterone, progestin-testosterone combinations, LHRH analogues with and without testosterone substitution; and (iii) selective inhibition of spermatogenesis by gossypol, a phenolic compound from cotton plant. Whether one of these methods will reach the desired goal for male fertility control has yet to be determined.
PIP: Increasing social attitudes toward a shared acceptance of fertility control have caused the medical and scientific field to research and develop new methods of male contraception. The established methods of condom and vasectomy do not meet all of the requirements necessary to be considered optimum male contraception. Although vasectomy is considered highly successful with a small percentage of failures or side-effects, it is not reversible. Another method of contraception in males, hormonal sperm suppression, causes undesirable side effects. Androgens, estrogens and progestins all inhibit sperm production but also may cause a loss in libido, cardiovascular disease or other longterm health hazards. LHRH agonists decrease testicular functions within a short period of a time but also cause a decrease in libido. The efficacy of this method needs further study. Lastly, gossypol, an anti-fertility compound used in the People's Republic of China, has a proven efficacy of 99.9%, but further studies need to be pursued to determine reversibility, toxicity and dosage.