Male Permanent Contraception: Vasectomy

Patel, Jasmine; Wachs, Barton

doi:10.1007/978-3-030-46391-5_13

Cited by 1 publication

(1 citation statement)

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“…[6,7] Vasectomy, also with the development of no-scalpel vasectomy (NSV), has become a method of choice but is used only by 6-8% of couples worldwide, and < 3% in Asian countries. [8][9][10] Vasectomy, though considered the most reliable method of male contraception, is not entirely free of impediments. At times, concerns have been expressed that vasectomy may elevate the risk of cancer, cardiovascular, and immune-related diseases.…”

Section: Introductionmentioning

confidence: 99%

RISUG® offers early contraception: An experience during Phase III clinical trials

Lohiya

Ansari

Sadasukhi

et al. 2022

JRHM

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Objectives: An early contraceptive efficacy with reasonable assurance of reversibility has been a challenge in male contraception. With nearly four decades of research in reversible inhibition of sperm under guidance (RISUG®) as an intravasal male contraceptive, including pre-clinical trials in rats, rabbits, langur monkeys, and three phases of clinical trials, the present study aims to evaluate the additional parameters of a center of Phase III clinical trials. Material and Methods: Subjects were recruited following ICMR guidelines of inclusion and exclusion criteria. Samples were analyzed for sperm functional tests, namely, hypo-osmotic swelling, acrosomal intactness, nuclear chromatin decondensation, and sperm mitochondrial activity index. Furthermore, seminal biochemistry and serum hormones such as follicle-stimulating hormone, luteinizing hormone, testosterone, cortisol, and prolactin were assessed along with levels of anti-sperm antibodies and prostate-specific antigen (PSA). Results: The present study, on human subjects, emphasizes the efficacy of RISUG® with early onset of contraception and indication of a greater possibility of reversal. A significant decrease in all sperm functional parameters was observed following RISUG® injection along with increased sperm abnormalities. Semen biochemistry revealed no marked alterations in the concentration of fructose and acid phosphatase, while significantly decreased levels of glycerophosphorylcholine and neutral α-glucosidase were observed. No significant changes in the circulatory levels of hormones and the levels of PSA were observed. In addition, the development of anti-sperm antibodies, an adverse effect of other vas occlusive methods, was not indicated after RISUG® administration, implying the potential of reversibility in humans as observed earlier in different animal models. Conclusion: RISUG® presenting deleterious effects on spermatozoa and marked alterations in epididymal markers provides early contraception with a greater possibility of reversal. Although the progress of RISUG® toward development as an ideal male contraceptive is slow, the study implies a strong future possibility.

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