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• W1968417448 abstract "The limited attempts to develop male contraceptive agents are of 3 major types interference with hormonal control of the testes disruption of spermatogenesis by drugs acting directly on the testes or interference with post-testicular maturation of spermatozoa. It has long been known that suppression of gonadotropin secretions from the pituitary could be achieved by the use of progestins and estrogens and the men treated showed reduced sperm counts. The resulting decline in testosterone was accompanied by a decline in libido and potency. Recent studies have demonstrated that testosterone itself in adequate doses results in suppression of gonadotropin secretion and decline in spermatogenesis without alteration in libido. However long-acting esters of testosterone had to be given by injection every 10-12 days posing a problem for use as a male contraceptive. Side effects were minor but the suppression of spermatogenesis was variable and some men initially achieving azoospermia had variable recovery of sperm count despite continued treatment. A number of combinations of androgens and progestogens have been shown in small scale clinical trials to produce oligospermia or azoospermia. The most effective combination medroxyprogesterone acetate (200 mg/month) and testosterone enanthate (250 mg/month) in a single monthly injection led to azoospermia in 66% of the men and oligospermia in the remainder. No significant side effects were noted but the lag times for onset of suppression and recovery of spermatogenesis could pose a problem in contraceptive use and the contraceptive efficacy of oligospermia in normal men is not known. Extensive attempts to modify the structure of gonadotropin releasing hormone (GnRH) have resulted in development of agonistic and antagonistic analogs with antifertility effects. Further work is needed to determine whether complete suppression of spermatogenesis can be achieved and in addition to counteract the decline of libido and potency resulting from decline in plasma testosterone associated with their use. It is clear that any drug affecting rapidly dividing cells will interfere with spermatogenesis but the stem cells and spermatogonia must be spared if the process is to be reversible. Many of the compounds studied affect other cell systems or deplete the stem cell population so severely that recovery does not occur. Studies of the polyphenolic compound gossypol used by over 8000 men in China showed that 99% of subjects achieved azoospermia or oligospermia after 2-5 months of treatment but in about 30% of cases spermatogenesis did not recover. Further toxicity studies are needed. Several agents have been identified that interfere with sperm maturation in the epididymis apparently by reducing sperm glycolysis and thus motility but their toxic effects have been unacceptable." @default.
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• W1968417448 date "1983-01-01" @default.
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• W1968417448 title "Agents for male fertility control" @default.
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• W1968417448 doi "https://doi.org/10.1016/0165-6147(83)90371-1" @default.
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