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Approaches to Hormonal Male Contraception

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Andrology

Abstract

Of all the different experimental approaches and pharmacological methods tested so far for male contraception, hormonal methods come closest to fulfilling the criteria set out above (see Chap. 27). The endocrine feedback mechanism operating between hypothalamus, pituitary and testes is the basis on which hormonal approaches to male contraception rest. Its goal is to suppress spermatogenesis and to reduce sperm concentration, if possible to azoospermia or at least to a sperm concentration low enough to provide contraceptive protection (<1 million sperm per ml ejaculate).

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References

  • Barfield A, Melo J, Coutinho E, Alvarez-Sanchez F, Faundes A, Brache V, Leon P, Frick J, Bartsch G, Weiske WH, Brenner P, Mishell D Jr, Bernstein G, Ortiz A (1979) Pregnancies associated with sperm concentrations below 10 million/ml in clinical studies of a potential male contraceptive method, monthly depot medroxyprogesterone acetate and testosterone esters. Contraception 20:121–127

    Article  CAS  PubMed  Google Scholar 

  • Bebb RA, Anawalt BD, Christensen RB, Paulsen CA, Bremner WJ Matsumoto AM (1996) Combined administration of levonorgestrel and testosterone induces more rapid and effective suppression of spermatogenesis than testosterone alone: A promising male contraceptive approach. J Clin Endocrinol Metab 81:757–762

    Article  CAS  PubMed  Google Scholar 

  • Behre HM, Kliesch S, Keck C, Simoni M, Nieschlag E (1995) Potential of testosterone buciclate for male contraception: Endocrine differences between responders and nonre-sponders. J Clin Endocrinol Metab 80:2394–2403

    Article  CAS  PubMed  Google Scholar 

  • Behre HM, Kliesch S, Lemcke B, von Eckardstein S, Nieschlag E (2001) Suppression of spermatogenesis to azoospermia by combined administration of GnRH antagonist and 19-nort-estosterone cannot be maintained by this non-aromatizable androgen alone. Hum Reprod 16:2570–2577

    Article  CAS  PubMed  Google Scholar 

  • Behre HM, Wang C, Handelsman DJ, Nieschlag E (2004) Pharmacology of testosterone preparations. In: Nieschlag E, Behre HM (eds) Testosterone: Action, Deficiency, Substitution, 3rd edn. Cambridge University Press, Cambridge, pp 405–444

    Chapter  Google Scholar 

  • Brady BM, Walton M, Hollow N, Kicman AT, Baird DT, Anderson RA (2004) Depot testosterone with etonogestrel implants result in induction of azoospermia in all men for long-term contraception. Hum Reprod 19:2658–2667

    Article  CAS  PubMed  Google Scholar 

  • Grimes DA, Lopez LM, Gallo MF, Halpern V, Nanda K, Schulz KF (2007) Steroid hormones for contraception in men (review). Cochrane Database Syst Rec 004316

    Google Scholar 

  • Gu YQ, Wang XH, Xu D, Peng L, Cheng LF, Huang MK, Huang ZJ, Zhang GY (2003) A multicenter contraceptive efficacy study of injectable testosterone undecanoate in healthy Chinese men. J Clin Endocrinol Metab 88:562–568

    Article  CAS  PubMed  Google Scholar 

  • Gu Y, Liang X, Wu W, Liu M, Song S, Cheng L, Bo L, Xiong Ch, Wang X, Liu X, Peng L, Yao K (2009) Multicenter contraceptive efficacy trial of injectable testosterone undecanote in healthy Chinese men. J Clin Endocrinol Metab 94:1910–1915

    Article  CAS  PubMed  Google Scholar 

  • Heckel M (1939) Production of oligospermia in a man by the use of testosterone propionate. Proc Soc Exp Biol Med 40:658–659

    Google Scholar 

  • Heinemann K, Saad F, Wiesemes M, White S, Heinemann L (2005) Attitudes toward male fertility control: Results of a multinational survey on four continents. Hum Reprod 20:549–556

    Article  PubMed  Google Scholar 

  • Kamischke A, Nieschlag E (2004) Progress towards hormonal male contraception. TRENDS in Pharmacological Sciences 25:49–57

    Article  CAS  PubMed  Google Scholar 

  • Kamischke A, Diebacker J, Nieschlag E. (2000a) Potential of nore-thisterone enanthate for male contraception: Pharmacokinetics and suppression of pituitary and gonadal function. Clin Endocrinol 53:351–358

    Article  CAS  Google Scholar 

  • Kamischke A, Plöger D, Venherm S, von Eckardstein S, von Eckardstein A, Nieschlag E (2000b) Intramuscular testosterone undecanoate with or without oral levornorgestrel: A randomized placebo-controlled feasability study for male contraception. Clin Endocrinol 53:43–52

    Article  CAS  Google Scholar 

  • Kamischke A, Venherm S, Plöger D, von Eckardstein S, Nieschlag E (2001) Intramuscular testosterone undecanoate and norethisterone enanthate in a clinical trial for male contraception. J Clin Endocrinol Metab 86:303–309

    Article  CAS  PubMed  Google Scholar 

  • Kamischke A, Heuermann T, Krüger K, von Eckardstein S, Schellschmidt I, Rübig A, Nieschlag E (2002) An effective hormonal male contraceptive using testosterone undecano-ate with oral or injectable norethisterone preparations. J Clin Endocrinol Metab 87:530–539

    Article  CAS  PubMed  Google Scholar 

  • Kinniburgh D, Anderson RA, Baird DT (2001) Suppression of spermatogenesis with desogestrel and testosterone pellets is not enhanced by addition of finasteride. J Androl 22:88–95

    CAS  PubMed  Google Scholar 

  • Knuth UA, Behre HM, Belkien L, Bents H, Nieschlag E (1985) Clinical trial of 19-nortestosterone-hexyloxyphenypropionate (Anadur) for male fertility regulation. Fertil Steril 44:814

    CAS  PubMed  Google Scholar 

  • Knuth UA, Yeung CH, Nieschlag E (1989) Combination of 19-nortestosterone-hexyloxyphenylpropionate (Anadur) and depot-medroxyprogesterone-acetate (Clinovir) for male contraception. Fertil Steril 51:1011

    CAS  PubMed  Google Scholar 

  • Liu PY, Swerdloff RS, Christenson PD, Handelsman DJ, Wang C, Hormonal Male Contraception Summit Group (2006) Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: An integrated analysis. Lancet 367:1412–1420

    Article  CAS  PubMed  Google Scholar 

  • Liu PY, Swerdloff RS, Anaawalt BD, Anderson RA, Bremner WJ, Elliesen J, Gu YQ, Kersemaekers WM, McLachlan, RI, Meriggiola MC, Nieschlag E, Sitruk-Ware R, Vogelsong K, Wang XH, Wu FC, Zitzmann M, Handelsman DJ, Wang C (2008) Determinants of the rate and extent of spermatogenic suppression during hormonal male contraception: An integrated analysis. J Clin Endocrinol Metab 93:1774–1783

    Article  CAS  PubMed  Google Scholar 

  • McLachlan RI, McDonald J, Rushford D, Robertson DM, Garrett C, Baker HW (2000) Efficacy and acceptability of testosterone implants, alone or in combination with a 5alpha-reductase inhibitor, for male hormonal contraception. Contraception 62:73–78

    Article  CAS  PubMed  Google Scholar 

  • Meriggiola MC, Costantino A, Cerpolini S, Bremner WJ, Huebler D, Morselli-Labate AM, Kirsch B, Bertaccini A, Pelusi C, Pelusi G (2003) Testosterone undecanoate maintains spermatogenic suppression induced by cyproterone acetate plus testosterone undecanoate in normal men. J Clin Endocrinol Metab 88:5818–5826

    Article  CAS  PubMed  Google Scholar 

  • Meriggiola MC, Costantino, SF, D'Emidio L, Morselli Labate AM, Bertaccini A, Bremner WJ, Rudolph I, Ernst M, Kirsch B, Martorana G, Pelusi G (2005) Norethisterone enanthate plus testosterone undecanoate for male contraception: Effects of various injection intervals on spermatogene-sis, reproductive hormones, testis, and prostate. J Clin Endocrinol Metab 90:2005–2014

    Article  CAS  PubMed  Google Scholar 

  • Mommers E, Kersemaeker WM, Elliesen J, Kepers M, Apter D, Behre HM, Beynon J, Bouloux PM, Costantino A, Gerbershagen HP, Gronlund L, Heger-Mahn D, Huhtaniemi I, Koldewihn EL, Lange C, Lindenberg S, Meriggiola MC, Meuleman E, Mulder PFA, Nieschlag E, Perheentupa A, Solomon A, Väisälä L, W FC, Zitzmann M (2008) Male hormonal contraception: A double-blind, placebo-controlled study. J Clin Endocrinol Metab 93:2572–2580

    Article  CAS  PubMed  Google Scholar 

  • Nieschlag E, 10th Summit Meeting Group (2007) 10th Summit Meeting on consensus: Recommendations for regulatory approval for hormonal male contraception. Contra ception 75:166–167, 22–23 October 2006

    Google Scholar 

  • Nieschlag E, Hoogen H, Bölk M, Schuster H, Wickings EJ (1978) Clinical trial with testosterone undecanoate for male fertility control. Contraception 18:607

    Article  CAS  PubMed  Google Scholar 

  • Nieschlag E, Kamischke A, Behre HM (2004) Hormonal male contraception: The essential role of testosterone. In: Nieschlag E, Behre HM (eds) Testosterone: Action, Deficiency, Substitution, 3rd edn. Cambridge University Press, Cambridge, pp 685–714

    Chapter  Google Scholar 

  • Page ST, Amory JK, Anawalt BD, Irwig MS, Brockenbrough AT, Matsumoto AM, Bremner WJ (2006) Testosterone gel combined with depomedroxyprogesterone acetate is an effective male hormonal contraceptive regimen and is not enhanced by the addition of a GnRH antagonist. J Clin Endocrinol Metab 91:4374–4380

    Article  CAS  PubMed  Google Scholar 

  • Page ST, Amory JK, Bremner WJ (2008) Advances in male contraception. Endocr Rev 29:465–493

    Article  CAS  PubMed  Google Scholar 

  • Qoubaitary A, Meriggiola C, Ng CM, Lumbreras L, Cerpolini S, Pelusi G, Christensen PD, Hull L, Swerdloff RS, Wang C (2006) Pharmacokinetics of testosterone undecanoate injected alone or in combination with norethisterone enanthate in healthy men. J Androl 27:853–867

    Article  CAS  PubMed  Google Scholar 

  • Swerdloff RS, Bagatell CJ, Wang C, Anawalt BD, Berman N, Steiner B, Bremner WJ (1998) Suppression of spermatogen-esis in man induced by Nal-Glu gonadotropin releasing hormone antagonist and testosterone enanthate (TE) is maintained by TE alone. J Clin Endocrinol Metab 83:3527–3533

    Article  CAS  PubMed  Google Scholar 

  • Turner L, Conway AJ, Jimenez M, Liu PY, Forbes E, McLachlan RI, Handelsman DJ (2003) Contraceptive effi-cacy of a depot progestin and androgen combination in men. J Clin Endocrinol Metab 88:4659–4667

    Article  CAS  PubMed  Google Scholar 

  • von Eckardstein S, Noe G, Brache V, Nieschlag E, Croxatto H, Alvarez F, Moo-Young A, Sivin I, Kumar N, Small M, Sundaram K, International Committee for Contraception Research, The Population Council (2003) A clinical trial of 7 alpha-methyl-19-nortestosterone implants for possible use as a long-acting contraceptive form en. J Clin Endocrinol Metab 88:5232–5239

    Article  Google Scholar 

  • Waites GMH (2003) Development of methods of male contraception: Impact of the World Health Organization Task Force. Fertil Steril 80:1–15

    Article  PubMed  Google Scholar 

  • Wang C, Wang XH, Nelson AL (2005) Levonorgestrel implants enhanced the suppression of spermatogenesis by testosterone implants: Comparison between Chinese and non-Chinese men. J Clin Endocrinol Metab 91:460–470

    Article  PubMed  Google Scholar 

  • Wang C, Cui YG, Wang XH, Jia Y, Hikim AS, Lue YH, Tong JS, Qian LX, Sha JH, Zhou ZM, Hull L, Leung A, Swerdloff RS (2007) Transient scrotal hyperthermia and levonorgestrel enhance testosterone-induce spermatogenesis suppression in men through increased germ cell apoptosis. J Clin Endocrinol Metab 92:3292–3304

    Article  CAS  PubMed  Google Scholar 

  • Wenk M, Nieschlag E (2006) Male contraception: a realistic option? European Journal of Contraception and Reproductive Health 11:69–80

    Article  Google Scholar 

  • WHO Task Force on Methods for the Regulation of Male Fertility (1990) Contraceptive efficacy of testosterone-induced azoospermia in normal men. Lancet 336:955–959

    Article  Google Scholar 

  • WHO Task Force on Methods for the Regulation of Male Fertility (1993) Comparison of two androgens plus depot-medroxy-progesterone acetate for suppression to azoospermia in Indonesian men. Fertil Steril 60:1062

    Google Scholar 

  • WHO Task Force on Methods for the Regulation of Male Fertility (1996) Contraceptive efficacy of testosterone-induce azoospermia and oligozoospermia in normal men. Fertil Steril 65:821–829

    Google Scholar 

  • WHO (2005) Controlled trials register NET-EN plus TU as a male contraceptive (WHO-HRP ID A25165) (accessed 2005-11-29). http://www.who.int/reproductive-health/rhl/a25165.html

  • Wu FC, Balasubramanian R, Mulders TM, Coeling-Benning HJ (1999) Oral progestogen combined with testosterone as a potential male contraceptive: additive effects between des-ogestrel and testosterone eanthate in suppression of sper-matogenesis, pituitary-testicular axis, and lipid metabolism. J Clin Endocrinol Metab 84:112–122

    Article  CAS  PubMed  Google Scholar 

  • Zhang GY, Gu YQ, Wang XH, Cui YG, Bremner WJ (1999) A clinical trial of injectable testosterone undecanoate as a potenctial male contraceptive in normal Chinese men. J Clin Endocrinol Metab 84:3642–3647

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Eberhard Nieschlag .

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Nieschlag, E., Behre, H.M. (2010). Approaches to Hormonal Male Contraception. In: Nieschlag, E., Behre, H.M., Nieschlag, S. (eds) Andrology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-78355-8_29

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  • DOI: https://doi.org/10.1007/978-3-540-78355-8_29

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-78354-1

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