Have you ever wondered why there isn't a birth control method for men — aside from the permanence of vasectomy and the condom — like there is for women? Something simple, easy to administer, commonly available, and covered by health insurance? Wouldn't it be great if both men and women could take control of their fertility, preventing unwanted (or unready-for) kids?
I have, and recently I got a chance to talk to Dr. John Helsa
at Oregon Reproductive Medicine, who is a "a board-certified reproductive endocrinologist who specializes in the treatment and care of patients with endocrine and infertility issues."
Starre Vartan for MNN: You're a doctor who specializes in infertility. How does understanding the physical challenges of conception advance the study of the opposite — birth control?
Dr. John Helsa: It's important to understand the physiological basis of infertility in men, which includes how sperm are being made. It's two sides of the same coin. Researchers focus on the mechanism of sperm production to further understand male fertility, which also helps us understand how to prevent conception.
What are the baseline needs for a male contraceptive to be accepted by both doctors and patients?
For a contraceptive method to be widely utilized, it has to be close to 100 percent effective, easy to administer, reversible, inexpensive, and have few or no side effects.
Why haven't we seen a male birth control pill yet?
Part of the problem is that it has to be reliable. It can't work only 50 percent of the time. It's just been harder to create a reliable contraceptive method for men because of the way their bodies work. However, today there are a lot more — and better — tools available to understand dysfunction as well as normal physiology that we didn't have before. Through advances in microbiology and genetics, researchers are able to target and ID mutations in lab animals to understand the normal processes by which sperm are being made. Being able to do the advanced DNA research is more commonplace and available than it was 20 years ago.
Why is developing a male contraceptive so much more challenging that those for women?
One of the primary problems we've had developing male contraceptive is the means to reduce hormone function in men. You could give men hormones to reduce sperm production like progesterone, but that also has negative effects on libido. We can't give men testosterone because it doesn't reduce sperm production to 0, so it's not foolproof as a contraceptive agent.
So what's the most promising method out there?
As a result of the challenges with hormones, researchers are looking for other nonhormonal methods to prevent sperm from being made. One promising study is looking at the protein being made by a Sertoli cell — if they can prevent that from being made, sperm don't mature fully, so they could not fertilize the egg. If we can prevent the Sertoli cell from making protein, we can stop sperm but not affect men's libido or sexual function. So that would be ideal.
What's great about it is that it does appear to be a method that wouldn't affect testosterone production. But we do need to do more research first and then there would need to be clinical trials in animals, and then later, people.
What's next for male birth control? And how long will it take to perfect it?
Next we will try to find a way in normal animals for the body to not make this protein, and see how effective it is and if there are any side effects. And this would have to be something that would be reversible. Realistically, it would probably take at least 10 years.