Introduction
Male contraceptives also referred to as male birth control, are methods of preventing pregnancy that solely involve the male physiology. Much of our current global increase is unintended. It’s estimated that half all conceptions are unplanned and half the resulting pregnancies are undesired. Approximately half unintended pregnancies are due to a failure to use contraception, and therefore the spouse to difficulties with contraceptive use or method failure. Moreover, in developing countries contraception use is further limited by restricted access to several available methods, both economically and culturally.
The most common sorts of Male contraceptives include condoms, outercourse, and vasectomy. A perfect contraceptive for men should be easily available, cheap, easy to use, without side effects, not affect libido, and simply reversible. The concept of male contraceptives is comparatively well-received across the planet. Most men and ladies in various studies found the thought of male contraceptive use agreeable.
However, there are multiple religious, educational, economic, and cultural barriers standing within the way of Male contraceptives. When the clinical trials were done on contraception are examined, it’s seen that the majority of them have to target female contraceptive methods. A couple of trials on male contraceptives have actually been withdrawn. However, the concept of hormonal and non-hormonal male contraceptive methods is highly alluring given the acceptability and potential marketing prospects if such a drug comes into existence.
Male contraceptives methods
1. Vasectomy
Vasectomy may be a simple surgery performed under local anesthesia wherein the ductus different is isolated and brought out from the scrotum through an incision followed by division and ligation. It’s a secure outpatient procedure used everywhere the planet as a male contraceptive option. Many modified techniques of vasectomy are in use. Within the ‘no-scalpel technique’, an easy scrotal puncture is formed for the identification of vas which is successively divided and occluded.
The benefits of the no-scalpel technique include minimal blood loss and low rates of infection. The speed of unwanted pregnancies after vasectomy is usually but 1%. However, there’s a delay within the development of azoospermia and effective contraception after the surgery which necessitates the utilization of an alternate contraceptive like condoms during this era. Another disadvantage of vasectomy is that the reversibility of procedure isn’t always successful. Because the time elapsed from the procedure increases, the reversibility rate comes down.
In fact, many patients can also develop anti-sperm antibodies which can also bring down the birthrate. Regardless of the surgical method used, the surgical experience could also be a crucial player within the success rate of vasectomy and its reversal. In experienced hands, complications like blood loss, and infections are minimal. However, a big number of men complain of testicular discomfort post vasectomy.
2. Retrograde ejaculation
Intentional retrograde ejaculation (coitus Saxonic) may be a primitive sort of Male contraceptives. It involves squeezing the urethra at the bottom of applying pressure to the perineum during orgasm. However, the practice isn’t considered a reliable method compared to the latest sorts of contraception.
3. Condoms
A condom may be a sheath-shaped barrier device that will be used during sexual activity to scale back the probability of pregnancy. It’s rolled onto an erect penis before intercourse and blocks ejaculated semen from entering the sexual partner’s genital system. With perfect use, the pregnancy rate of condoms is 2%. Condoms could also be combined with other sorts of contraception (such as spermicide) for greater protection.] The standard use pregnancy rate among condom users varies counting on the population being studied, starting from 10 to 18%.
4. Non-hormonal method
Non-hormonal targets of contraception include sperm production at the testicular level, sperm maturation at the extent of the epididymis, and sperm motility. Obviously, the selectivity, specificity and lesser side effects compared to hormonal methods make these approaches attractive. However, many of those are experimental and in several phases of development.
5. Triptolide
Triptolide may be a Chinese herbal extract from Trypterigium wilfordii, which was shown to scale back sperm motility and density. However, in animal experiments, the consequences were irreversible and therefore the compound was also found to possess immunosuppressive properties.
6. Indenopyridines
Indenopyridines are experimental compounds in development that may affect the Sertoli cells and germ cells. Studies with l-CDB-4022 an indenopyridine have shown that it activates the ERK/MAPK (mitogen-activated protein kinase) pathway, reduces expression of prosurvival factors, alters expression of Sertoli-germ cell adherens junction proteins, disrupts Sertoli cell microtubule structure, and induces the proapoptotic factor, Fas, which successively, within the end, may end in reproductive cell loss. When it had been utilized in combination with a gonadotropin-releasing hormone (GnRH) antagonist, it induced reversible infertility in male rats. Gonadotropin and sex steroid concentrations were unaffected and there have been no overt toxicities when the drug was administered in monkeys.
7. Adjudin
Adjudin may be a derivative of lonidamine which was developed as an anticancer drug. Adjudin was shown to disturb the adhesion between Sertoli cells and germ cells. The effect was quite rapid and round spermatids and spermatocytes got detached within 3-6 days of treatment.[24] Other significant changes included retraction of the Sertoli cell cytoplasm, the formation of huge vacuoles and the presence of multinucleated germ cells, and the relocation of Sertoli cell nuclei to a better position within the seminiferous epithelium. striated muscle atrophy and liver inflammation were seen within the male rats treated with adjudging.
To bypass these effects, an attempt was made to conjugate adjudin with recombinant mutant follicle-stimulating hormone (FSH) protein in order that a testis-specific delivery might be made. While overall drug exposure was reduced, infertility induction was relatively good.
8. Epididymis targets
During transit through the epididymis, before ejaculation, spermatozoa undergo maturation; thus the epididymis provides another possibly unique contraceptive target. Murine genetic knockout models have provided a variety of putative epididymis targets; however, none have reached clinical testing in humans or nonhuman primates.
Epididymis-specific proteins could provide points for pharmaceutical intervention. for instance, the G-coupled protein receptor HE6 appears to possess epididymis duct-specific expression, and HE6-deficient mice are infertile but otherwise phenotypically normal. HE6 appears to be critical to fluid restoration within the efferent epididymis ductless, but its precise mechanism of action isn’t documented. Nevertheless, G-coupled protein receptors are often excellent targets for drug development.
Similarly, CRISP-1, a member of the cysteine-rich secretory protein family, appears to possess epididymis-specific expression. CRISP-1 appears to be secreted into the lumen of the epididymis where it’s postulated to interact with spermatozoa, preventing the initiation of capacitation during sperm transit and storage. The pursuit of those, and other, epididymis proteins as contraceptive targets, however, remains a variety of years from clinical use because not only do appropriate inhibitors got to be identified, but their specificity and concentration within the reproductive tract will be got to be confirmed.
The assumption about Male contraceptives
Contraception is taken into account to be the key answer to social control. Though there are quite a few researches in male contraceptive methods, the particular pharmacological marketing of the products hasn’t materialized in a promising way. This has led to lacunae in contraceptive choices available to men at the present. Most men choose vasectomy and condoms as contraceptive options now. Combinations of testosterone with progestin and newer SARMs have shown good results. Other non-hormonal approaches supported sperm and epididymis targets have exciting possibilities.
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